Exacerbations of COPD: quantifying the patient's perspective using discrete choice modelling

Haughney, John; Partridge, Martyn R; Vogelmeier, Claus; Larsson, Thomas; Kessler, Romain; Ståhl, Elisabeth; Brice, Roger; Löfdahl, Claes-Göran

doi:10.1183/09031936.05.00142704

Cited by 57 publications

(47 citation statements)

References 35 publications

(38 reference statements)

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“…30 A third of these patients will be seen again or admitted to hospital within the subsequent eight weeks. 31 This would seem to be an area where good studies are needed to determine whether technology can aid identification of those making a delayed recovery and to prompt identification of those needing further treatment or readmission.…”

Section: Copdmentioning

confidence: 99%

Technology and its role in respiratory care

Smith

Elkin

Partridge

2009

Primary Care Respiratory Journal

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Introduction: Telemonitoring, telemedicine, clinical and medical informatics or telecare, are terms used to describe the use of technology along with local clinical protocols to monitor remotely a patient's medical condition in their own home. In respiratory medicine, where large numbers of people have long term conditions such as asthma and chronic obstructive pulmonary disease (COPD), the role of such monitoring technology in the management of patients is of great interest.

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Section: Copdmentioning

confidence: 99%

Technology and its role in respiratory care

Smith

Elkin

Partridge

2009

Primary Care Respiratory Journal

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“…The patients also experienced life anxiety, which relates to the fear of living a life with disabling breathlessness, which gave them a fear of the future. In relation to the nature of dyspnea, it could be inferred that participation in patient education that results in a non-deterioration in COPD is beneficial for the patient [23,24]. The fact that dyspnea was significantly worse at baseline in the participation group compared to the non-participation group, could indicate that patients with more severe dyspnea were more inclined to participate in patient education.…”

Section: Discussionmentioning

confidence: 99%

Influences of patient education on exacerbations and hospital admissions in patients with COPD – a longitudinal national register study

Henoch

Ekberg-Jansson²

2018

European Clinical Respiratory Journal

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Introduction: Chronic obstructive pulmonary disease (COPD) contributes to impaired health-related quality of life (HRQoL). Patient education and smoking cessation programs are recommended to reduce the number of exacerbations and hospitalizations, but the effects of such programs have yet to be explored in larger samples. Objective: The aim was to explore the longitudinal effects of patient education and smoking cessation programs on exacerbations and hospital admissions in patients with COPD. Design: This is a register study where data from the Swedish National Airway Register, including 20,666 patients with COPD, were used. Baseline measures of demographic, disease-related, and patient-reported variables were compared with a follow-up, 10–30 months after baseline. Descriptive statistics and changes between baseline and follow-up were calculated. Results: Comparing those not participating in education programs to those who did, HRQoL deteriorated significantly between baseline and follow-up in non-participants; there was no change in either exacerbations or hospitalizations in either group; there was a significant difference in baseline HRQoL between the two, and, when controlling for this, there was no significant change (p = 0.73). Patients who participated in smoking cessation programs were younger than the non-participants; mean 66.0 (standard deviations (SD) 7.8) vs. mean 68.1 (SD 8.8), p = 0.006. Among participants in smoking cessation programs, the proportion with continued smoking decreased significantly, from 76% to 66%, p < 0.001. Exacerbations at follow-up were predicted by FEV1% of predicted value and exacerbations at baseline. Hospital admissions at follow-up were predicted by baseline FEV1% of predicted value and exacerbations at baseline. Conclusions: To prevent exacerbations and hospital admissions, treatment and prevention must be prioritized in COPD care. Patient education and smoking cessation programs are beneficial, but there is a need to combine them with other interventions.

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“…3 Early discharge and hospital in the home interventions, widely used in the management of exacerbations, are safe, 8 cost effective. 6,9 preferential to patients7 and save hospital bed days.…”

Section: Discussionmentioning

confidence: 99%

“…2 Exacerbations of the disease account for up to one in eight emergency hospital admissions in the UK and recurrent hospitalizations, particularly feared by COPD patients, 3,4 contribute signifi cantly to disease morbidity. Effective management strategies that have been studied include early discharge/hospital in the home interventions and self-management education.…”

Section: Introductionmentioning

confidence: 99%

Early discharge care with ongoing follow-up support may reduce hospital readmissions in COPD

Lawlor

Kealy²,

Agnew³

et al. 2008

COPD

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Background: Early discharge care and self-management education, although effective in the management of chronic obstructive pulmonary disease (COPD), do not typically reduce hospital re-admission rates for exacerbations of the disease. We hypothesized that a respiratory outreach programme that comprises early discharge care followed by continued rapid-access out-patient support would reduce the need for hospital readmission in these patients. Methods: Two hundred and forty-six patients, acutely admitted with exacerbations of COPD, were recruited to the respiratory outreach programme that included early discharge care, followup education, telephone support and rapid future access to respiratory out-patient clinics. Sixty of these patients received self-management education also. Emergency department presentations and admission rates were compared at six and 12 months after, compared to prior to, participation in the programme for the same patient cohort. Results: The frequency of both emergency department presentations and hospital admissions was signifi cantly reduced after participation in the programme. Conclusions: Provision of a respiratory outreach service that includes early discharge care, followed by education, telephone support and ongoing rapid access to out-patient clinics is associated with reduced readmission rates in COPD patients.

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Exacerbations of COPD: quantifying the patient's perspective using discrete choice modelling

Cited by 57 publications

References 35 publications

Technology and its role in respiratory care

Technology and its role in respiratory care

Influences of patient education on exacerbations and hospital admissions in patients with COPD – a longitudinal national register study

Early discharge care with ongoing follow-up support may reduce hospital readmissions in COPD

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