Source: International Congress 2014 – COPD: points to ponder
Disease area: Airway diseases

Abstract

IntroductionCOPD is characterised by an increased risk of hospital readmission due to recurrent acute exacerbations (AECOPD). The effectiveness of ICI at preventing hospitalisations in COPD patients is controversial.AimThe effect of 2-year follow-up ICI on hospital admission due to AECOPD was examined.MethodsThe ICI, shared among primary care, hospital chest physician and nurse care team, consisted of educational program with individually tailored care plan, specialist supervision during scheduled visits, phone contact and home visit by nurse care team, with support of information technologies. COPD patients recruited from outpatient clinics of Massa-Carrara sanitary district were followed for 2 years.ResultsEnrolled patients were divided into Group A (142 patients, 52% GOLD stages 2 and 3) with hospitalisation and Group B (214 patients, 55%GOLD stages 3 and 4) without hospitalization the year before enrolment.In Group A, 12-month ICI decreased the mean number of hospitalisations per patient/year (0.40 versus 1.44 the year pre-enrolment p<0.001) and reduced the percent readmissions by 73%; results unchanged in 2^nd-year follow-up. Gold stage 3 and 4 had the best clinical outcomes.In Group B, 18 ( 8.4%) out 214 patients were hospitalised in the 1^st year follow-up while 4.6% of patients were hospitalised in the 2^nd yr.ConclusionsThe study shows that a standardised ICI, based on shared care arrangements among different levels of the sanitary system, effectively prevents hospital readmission for AECOPD only in patients with previous hospitalisation. COPD patients without previous hospitalisation might be excluded, according to local resources.

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Citations should be made in the following way:
A. Porcu, F. Costa, M. Polselli, A. Macuzzi, B. Marsiglia, A. Casani, M. Moretti (Carrara, Italy). A disease-specific integrated care intervention (ICI) prevents hospital admission only in COPD patients with recurrent hospitalisation. Eur Respir J 2014; 44: Suppl. 58, 3632

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