What are the needs of patients following discharge from hospital after an acute exacerbation of chronic obstructive pulmonary disease (COPD)?

Gruffydd-Jones, Kevin; Langley-Johnson, Carol; Dyer, Christopher; Badlan, Kathryn; Ward, Sabbi

doi:10.3132/pcrj.2007.00075

Cited by 54 publications

(50 citation statements)

References 12 publications

(15 reference statements)

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“…One such long term condition is Chronic Obstructive Pulmonary Disease (COPD), a prevalent disease [1] characterised by progressive worsening of lung capacity, frequent hospital admissions, high levels of disability, and depression [3–5]. …”

Section: Introductionmentioning

confidence: 99%

Comparison of patient perceptions of Telehealth-supported and specialist nursing interventions for early stage COPD: a qualitative study

Fitzsimmons

Thompson

Bentley

et al. 2016

BMC Health Serv Res

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BackgroundThe increasing prevalence and associated cost of treating Chronic Obstructive Pulmonary Disease (COPD) is unsustainable, and focus is needed on self-management and prevention of hospital admissions. Telehealth monitoring of patients’ vital signs allows clinicians to prioritise their workload and enables patients to take more responsibility for their health. This paper reports the results of a qualitative study embedded within a feasibility and pilot Randomised Controlled Trial (RCT) of Telehealth-supported care within a community-based COPD supported-discharge service. The aim of the study was to qualitatively explore the experiences of patients with COPD who had received either a Telehealth-supported or a specialist nursing intervention following their discharge from hospital after an admission for a COPD exacerbation.MethodsPatients were invited to either participate in semi-structured interviews or to complete a semi-structured self-administered questionnaire on completion of the intervention. Nine patients were interviewed (67 % female) and seventeen patients completed the questionnaires. In addition, three clinicians responsible for the delivery of both interventions were interviewed to obtain their perspectives on the new services.ResultsSeven underlying themes emerged from the patient interviews and were further explored in the questionnaires: (1) patient demographics; (2) information received by the participants; (3) installation of the Telehealth technology; (4) Telehealth service functionality; (5) visits; (6) service withdrawal; and (7) service perceptions. Recipients of both services reported feelings of safety derived from the delivery of an integrated, community-based service.ConclusionsAlthough recipients of the Telehealth service received 50 % fewer home visits from the clinicians than recipients of a more traditional community-based nursing intervention, the patients were enthusiastic about the service, with some describing it as the best service they had ever received. This suggests that a Telehealth intervention is an acceptable alternative to a more traditional home nursing visit model for monitoring community-based patients with COPD following their discharge from hospital.Trial registrationCurrent Controlled Trials ISRCTN68856013Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1623-z) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Comparison of patient perceptions of Telehealth-supported and specialist nursing interventions for early stage COPD: a qualitative study

Fitzsimmons

Thompson

Bentley

et al. 2016

BMC Health Serv Res

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“…Episodic crises create the essence of uncertainty that defines the experience of COPD (Boyle, 2009a, Oliver, 2001, Gruffyd-Jones et al, 2007. These episodes are often described by patients and carers as near-death experiences that leave people with a constant sense of their own possible death.…”

Section: Living With Crisesmentioning

confidence: 99%

Psychosocial Dimensions of COPD for the Patient and Family

Gullick¹

2012

Chronic Obstructive Pulmonary Disease - Current Concepts and Practice

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“…Psychological and social concerns of patients after discharge from the hospital included high levels of anxiety, fear, and uncertainty associated with exacerbations of COPD, as exacerbation is associated with higher morbidity and readmission (Gruffydd-Jones, Langley-Johnson, Dyer, Badlan, & Ward, 2007). The CPMP From the initial visit to the second visit, the percentage of patients who knew how to take their medications properly increased from 52.2% to 87.9%.…”

Section: Discussionmentioning

confidence: 98%

Role of the Management Pathway in the Care of Advanced COPD Patients in Their Own Homes

Ramani

Pickston²,

Clark³

et al. 2010

Care Management Journals

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Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide, and the incidence and prevalence are rising every decade. The cost of hospital admission is substantial and is the single largest source of expenditure in care of COPD patients. Home-based intervention has been shown to provide long-term cost benefit in a range of chronic illnesses; however, the role of home visits by respiratory therapists (RT) in COPD management has not been evaluated. The aim of this study was to assess the efectiveness of a management pathway in the care of oxygen-dependent COPD patients in their homes. Oxygen-dependent COPD patients were enrolled in the management pathway after discharge from the hospital or referred from a provider's office. At least three home visits were made: the first within 3 days of enrollment; the second in 1 month, and the third 10 months later. Three hundred and twenty-four patients were enrolled in the study. During the study period the overall hospitalization rate dropped (11% per month at the second visit vs. 2.1% per month at the third visit). The patients' understanding of the disease improved substantially (21.6% vs. 83.9%), knowledge of medications the patients were taking improved (56.0% vs. 87.0%), and appropriate use of medications increased (52.0% vs. 86.0%). In our community, this RT-led program helped patients' self-management of COPD in their own homes by increasing understanding of the disease, assisted physicians in monitoring their patients, and reduced hospitalization.

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What are the needs of patients following discharge from hospital after an acute exacerbation of chronic obstructive pulmonary disease (COPD)?

Cited by 54 publications

References 12 publications

Comparison of patient perceptions of Telehealth-supported and specialist nursing interventions for early stage COPD: a qualitative study

Comparison of patient perceptions of Telehealth-supported and specialist nursing interventions for early stage COPD: a qualitative study

Psychosocial Dimensions of COPD for the Patient and Family

Role of the Management Pathway in the Care of Advanced COPD Patients in Their Own Homes

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