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

Abstract

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.

The Swedish National Airway Register (SNAR): development, design and utility to date

“…At that time, the variables in SNAR were modified to harmonize with these recommendations, which presents a unique opportunity to use data from SNAR to evaluate the effect of this national effort. Several papers presenting COPD data from SNAR have been published [19][20][21][22]; however, a comprehensive presentation of SNAR across the spectrum of obstructive lung disease has not yet been undertaken. Accordingly, this paper aims to describe the development and design of SNAR, and to study the 2019 data to evaluate its potential utility related to improvement of quality of care.…”

<p>Assessment of COPD-Related Knowledge Among Internal Medicine Nurses: A Cross-Sectional Study</p>

“…The COPD-related knowledge level in patients has been shown to correlate with their self-management behavior 17. In a longitudinal national register study comparing those not participating in education programs to those who did, the health-related quality of life (HRQoL) of non-participants deteriorated significantly 18. Collinsworth et al19 reported that the time to first all-cause and COPD-related readmission appeared shorter for patients receiving education.…”

Clinical Audits in Chronic Obstructive Pulmonary Disease: what for?

“…Notwithstanding, a considerable number of cases were active smokers 55 . This data must be a sign of alert and highlights the opportunity that the hospital admission should represent to advance in the process of smoking cessation putting into value the intra-hospital programs for smoking cessation 56 .…”