Abstract:
BACKGROUND:Chronic obstructive pulmonary disease (COPD) is a common disease worldwide with significant morbidity and mortality. AIM:To investigate the effect of a comprehensive COPD management programme in decreasing COPD readmissions 1 year before and 1 year after the programme. METHOD:185 (166 males) patients admitted for acute exacerbation of COPD (AECOPD) were recruited between September 2010 and December 2012. COPD care team provided crisis support and maintenance therapy for the COPD patients for a total of 16 weeks. The protocol included COPD clinic run by respiratory physicians, COPD education and nurse clinics by respiratory nurses, out-patient pulmonary rehabilitation programme by physiotherapists, fast track doctor's clinic, telephone hotline for patients and nurse telephone calls to patients. Readmissions over a period of 1 year were assessed. RESULTS:The mean (SD) age of the subjects and FEV1 % predicted normal were 76.9 ± 7.37 yrs and 44.4 ± 20.7% respectively. 40 (21.6%) patients required non-invasive positive pressure ventilation during the recruitment admission. Admissions for AECOPD decreased from 2.39 ± 2.05 one year before programme to 1.65 ± 2.1 one year after programme (mean difference 0.75 ± 2.11 episodes, p < 0.001). The length of hospital stay was reduced from 12.17 ± 9.14 days one year before programme to 9.09 ± 12.1 days one year after the programme (mean difference 3.09 ± 12.1 days, p < 0.001). The FEV1 percentage predicted and quality of life measured by St George's Respiratory Questionnaire showed no significant improvement at 16 weeks after recruitment into the programme as compared to at 6 weeks. CONCLUSION:COPD care programme is effective in decreasing readmissions and length of hospital day for COPD patients.
journal_name
Respir Medjournal_title
Respiratory medicineauthors
Ko FW,Ngai JC,Ng SS,Chan KP,Cheung R,Leung MY,Pun MC,Hui DSdoi
10.1016/j.rmed.2014.09.019subject
Has Abstractpub_date
2014-12-01 00:00:00pages
1771-8issue
12eissn
0954-6111issn
1532-3064pii
S0954-6111(14)00330-8journal_volume
108pub_type
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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