Interventions at presentation and discharge for patients with acute exacerbation of chronic obstructive pulmonary disease to reduce unnecessary admissions and readmissions: A scoping review protocol

MacDonell, Rachel; Woods, Orla; Prihodová, Lucia

doi:10.1002/nop2.423

Cited by 1 publication

(4 citation statements)

References 23 publications

(25 reference statements)

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“…The protocol for this scoping review, based on the methodological framework proposed by Arksey and O'Malley 22 and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 23 has previously been published. 24 Identifying relevant studies A search was undertaken for COPD studies relating to acute hospital-based care presentation, admission and discharge interventions as well as interventions aiming to reduce COPD admission(s) or readmission(s). English language, peer-reviewed studies published between January 2000 and September 2020 in the Web of Science, Embase (Elsevier) and PubMed electronic databases were included.…”

Section: Methodsmentioning

confidence: 99%

“…The protocol for this scoping review, based on the methodological framework proposed by Arksey and O’Malley 22 and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 23 has previously been published. 24 …”

Section: Methodsmentioning

confidence: 99%

“…Relevant articles were screened as previously described. 24 RM, LP and OW conducted independent title reviews against PICO criteria. All authors participated in abstract and full-text review.…”

Section: Methodsmentioning

confidence: 99%

“…Two researchers (RM and LP) designed a standardised Microsoft Excel datasheet for data extraction which was validated (RM and OW) using two randomly selected articles from the search results. Data items were extracted from each paper using the headings described previously 24 ; study descriptors, study design, intervention descriptors, measures, results, discussion and reviewer’s appraisal.…”

Section: Methodsmentioning

confidence: 99%

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Interventions to standardise hospital care at presentation, admission or discharge or to reduce unnecessary admissions or readmissions for patients with acute exacerbation of chronic obstructive pulmonary disease: a scoping review

et al. 2020

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IntroductionChronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that may be punctuated by episodes of worsening symptoms, called exacerbations. Acute exacerbations of COPD (AECOPD) are detrimental to clinical outcomes, reduce patient quality of life and often result in hospitalisation and cost for the health system. Improved diagnosis and management of COPD may reduce the incidence of hospitalisation and death among this population. This scoping review aims to identify improvement interventions designed to standardise the hospital care of patients with AECOPD at presentation, admission and discharge, and/or aim to reduce unnecessary admissions/readmissions.MethodsThe review followed a published protocol based on methodology set out by Arksey and O’Malley and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic database searches for peer-reviewed primary evidence were conducted in Web of Science, EMBASE (Elsevier) and PubMed. Abstract, full-text screening and data extraction were completed independently by a panel of expert reviewers. Data on type of intervention, implementation supports and clinical outcomes were extracted. Findings were grouped by theme and are presented descriptively.Results21 articles met the inclusion criteria. Eight implemented a clinical intervention bundle at admission and/or discharge; six used a multidisciplinary care pathway; five used coordinated case management and two ran a health coaching intervention with patients.ConclusionThe findings indicate that when executed reliably, improvement initiatives are associated with positive outcomes, such as reduction in length of stay, readmissions or use of health resources. Most of the studies reported an improvement in staff compliance with the initiatives and in the patient’s understanding of their disease. Implementation supports varied and included quality improvement methodology, multidisciplinary team engagement, staff education and development of written or in-person delivery of patient information. Consideration of the implementation strategy and methods of support will be necessary to enhance the likelihood of success in any future intervention.

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Section: Methodsmentioning

confidence: 99%