Frequent Outpatient Visits Prevent Exacerbation of Chronic Obstructive Pulmonary Disease

Abstract

to April 30, 2015. A definition of COPD was used based on the diagnosis code and medication. Frequent visitors were defined as subjects who visited the outpatient clinic for COPD three or more times per year. Among 159,025 subjects, 117,483 (73.9%) were classified as frequent visitors. Frequent visitors underwent pulmonary function tests and used various inhalers more often than did infrequent visitors. the rates of copD exacerbation requiring admission to a general ward, emergency room, or intensive care unit were significantly lower in frequent visitors than in infrequent visitors. In multivariable analysis, frequent visits were identified as an independent factor preventing COPD exacerbation that required admission to a ward (odds ratio [OR], 0.387), emergency room, (OR, 0.558), or intensive care unit (OR, 0.39) (all P < 0.001). In conclusion, we showed frequent outpatient visits reduce the risk of COPD exacerbation by 45-60%.Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease of the airways that requires lifelong management 1 . A report from the Global Initiative for Chronic Obstructive Lung Disease have described routine patient follow-up as essential 2 . Lung function may worsen over time because of the natural history of COPD, so regular visits are needed to ensure frequent pulmonary function tests 3 . Symptoms and history of exacerbations should be monitored at these visits to adjust treatment, identify complications or comorbidities, and prevent acute exacerbations 4,5 . Frequent outpatient visits also offer patients an opportunity to improve their skills using inhalers, increase their knowledge of rehabilitation and nutritional support, and receive vaccination, all of which improve the clinical outcomes of COPD 6-9 . However, although there is good reason to believe that frequent outpatient visits have a prognostic benefit in COPD, there is insufficient scientific evidence to support this assumption.Until now, whether or not frequent outpatient visits have a prognostic benefit in COPD and how often patients should visit a hospital outpatient clinic to prevent exacerbations has never been investigated. The aim of this study was to determine whether or not frequent outpatient visits reduce the risk of exacerbation of COPD using data from a Korean national cohort study.

Clinic audit on Chronic Obstructive Pulmonary Disease (COPD) management in public primary care setting: Hong Kong experience

“…Lastly, relatively stable AECOPD patients had been managed locally with more frequent FU instead of being admitted to hospital, hence reducing the hospital burden. This is in line with findings in the literature that frequent outpatient visits prevent the exacerbation of COPD (31). With all these proactive interventions and efforts, the AECOPD rate leading to hospital admission was significantly reduced to 9.6% in Phase 2.…”

Chronic Obstructive Pulmonary Disease (COPD) management in the community: how could primary care team contribute?

“…Lastly, relatively stable AECOPD patients could be successfully managed at outpatient settings with more frequent FU instead of being admitted to hospital, hence reducing the hospital burden. This is in line with ndings in the literature which state that frequent outpatient visits prevent exacerbation of COPD (23).…”

Chronic Obstructive Pulmonary Disease (COPD) management in the community: how could primary care team contribute?

“…Lastly, relatively stable AECOPD patients could be successfully managed at outpatient settings with more frequent FU instead of being admitted to hospital, hence reducing the hospital burden. This is in line with findings in the literature which state that frequent outpatient visits prevent exacerbation of COPD [23]. With all these proactive interventions and efforts, the AECOPD rate leading to hospital admission was significantly reduced to 13.5% in Phase 2.…”