According to research, providing comprehensive individualized care for patients admitted to the hospital for acute exacerbation of COPD (AECOPD) did not reduce readmission rates but did reduce mortality. The study, conducted by Simon Adamson of the Centre for Heart Lung Innovation at St. Paul’s Hospital in British Columbia, was undertaken to determine whether or not an individualized care package delivered to an urban population of AECOPD patients would impact readmission rates at 30- or 90-days. Mortality rate was a secondary outcome measure, as indicated on an HCP Live news report.
Participants were drawn from two inner-city hospitals in British Columbia, and there was a total of 462 patients in the study, with 271 in the control group that did not receive a care package and 191 who did receive the care package. A physical therapist, nurse practitioner, and respiratory therapist assembled and delivered the care packages, which were individualized and based on patient needs, and consisted of four stages: initial contact, post discharge phone call, a home visit, and continued care, according to HCP Live.
The primary outcome measure of readmission rate was no different for the two groups; however, the 90-day readmission rate for women who received the care package was reduced, prompting the researchers to suggest that “females were more sensitive” to the care packages. Also, when all-cause mortality was examined, the control group “was found to have significantly increased all-cause mortality compared with the care package group with a hazard ratio equal to 2.455,” as indicated on the HCP Live report.
The study was limited by the retrospective design, the fact that each care package was “purposely unique,” and the high rates of mental illness and substance abuse among the participants. The researchers concluded, “We suspect that better and earlier recognition of exacerbations, improved self-management techniques, and availability of an Outreach Team for improving day-to-day disease management in the community could have contributed to the beneficial effects.”
Source: HCP Live