Stratification of COPD patients by previous admission for targeting of preventative care

Bryden, Clare; Bird, William; Titley, Helen; Halpin, David

doi:10.1016/j.rmed.2008.10.027

Cited by 15 publications

(10 citation statements)

References 20 publications

(16 reference statements)

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“…4 This may be because most admissions involve patients who would not be considered at high risk. 20 Therefore, new approaches are needed. Automated interactive telephone calls triggered by a health risk forecast are an innovative method for delivering proactive care on a large scale.…”

Section: Discussionmentioning

confidence: 99%

A randomised controlled trial of the effect of automated interactive calling combined with a health risk forecast on frequency and severity of exacerbations of COPD assessed clinically and using EXACT PRO

Halpin

Laing-Morton

Spedding

et al. 2011

Primary Care Respiratory Journal

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Section: Discussionmentioning

confidence: 99%

A randomised controlled trial of the effect of automated interactive calling combined with a health risk forecast on frequency and severity of exacerbations of COPD assessed clinically and using EXACT PRO

Halpin

Laing-Morton

Spedding

et al. 2011

Primary Care Respiratory Journal

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“…However, they account for only 8% and 22%, respectively, of winter admissions, as 70% of patients admitted have no previous admission in the preceding 12 months. 31 …”

Section: Seasonality Of Hospital Admissionmentioning

confidence: 99%

The causes and consequences of seasonal variation in COPD exacerbations

Donaldson

Wedzicha

2014

COPD

101

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The time of year when patients experience exacerbations of chronic obstructive pulmonary disease is a much-overlooked feature of the disease. The higher incidence of exacerbations in winter has important consequences for patients in terms of increased morbidity and mortality. The seasonality also imposes a considerable burden on already-overloaded health care services, with both primary care consultations and hospital admissions increasing in number. The seasonality of exacerbations varies with latitude, and is greater in more temperate climates, where there may be less protection from outdoor and indoor cold exposure. The precise causes of the seasonality are unknown, but thought to be partly due to the increased prevalence of respiratory viral infections circulating in cold, damp conditions. Increased susceptibility to viral infection may also be a mechanism mediated through increased airway inflammation or possibly reduced vitamin D levels. The seasonality of exacerbations informs us about the triggers of exacerbations and suggests possible strategies to reduce their number.

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“…Less attention has been paid to the influence of time of year on exacerbation occurrence and management. There is evidence of a seasonal variation in the rate of hospital admissions for COPD, with more exacerbations occurring during the winter months compared with summer [11][12][13]. Exacerbations are also associated with cooler temperatures [14,15].…”

mentioning

confidence: 99%

Seasonality and determinants of moderate and severe COPD exacerbations in the TORCH study

Jenkins

Celli²,

Anderson³

et al. 2011

European Respiratory Journal

197

152

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We investigated the impact of season relative to other determinants of chronic obstructive pulmonary disease (COPD) exacerbation frequency in a long-term international study of patients with forced expiratory volume in 1 s (FEV1) ,60% predicted. COPD exacerbations were defined by worsening symptoms requiring systemic corticosteroids and/or antibiotics (moderate) or hospital admission (severe). Seasonality effect was calculated as the proportion of patients experiencing an exacerbation each month.Exacerbations in the northern and southern regions showed an almost two-fold increase in the winter months. No seasonal pattern occurred in the tropics. Overall, 38% of exacerbations were treated with antibiotics only, 19% with systemic corticosteroids only and 43% with both, while 20% required hospital admission irrespective of the season. Exacerbation frequency was associated with older age, lower body mass index, lower FEV1 % pred and history of prior exacerbations. Females and patients with worse baseline breathlessness, assessed using the Medical Research Council (MRC) dyspnoea scale, exacerbated more often (rate ratio (RR) for male versus female 0.7, 95% CI 0.7-0.8 (p,0.001); RR for MRC dyspnoea score 3 versus 1 and 2 combined 1.1, 95% CI 1.1-1.2 (p,0.001)). The effect of season was independent of these risk factors.COPD exacerbations and hospitalisations were more frequent in winter.

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Stratification of COPD patients by previous admission for targeting of preventative care

Cited by 15 publications

References 20 publications

A randomised controlled trial of the effect of automated interactive calling combined with a health risk forecast on frequency and severity of exacerbations of COPD assessed clinically and using EXACT PRO

A randomised controlled trial of the effect of automated interactive calling combined with a health risk forecast on frequency and severity of exacerbations of COPD assessed clinically and using EXACT PRO

The causes and consequences of seasonal variation in COPD exacerbations

Seasonality and determinants of moderate and severe COPD exacerbations in the TORCH study

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