Comprehensive care programme for patients with chronic obstructive pulmonary disease: a randomised controlled trial

Area of Science:

• Pulmonary Medicine
• Clinical Trials
• Healthcare Management

Background:

• No prior randomized controlled trials (RCTs) specifically assessed comprehensive, multidisciplinary programs for post-hospital discharge COPD patients.
• Acute exacerbations of COPD (AECOPD) frequently lead to hospital readmissions.
• Effective post-discharge care is crucial for managing COPD patients.

Purpose of the Study:

• To evaluate if a comprehensive care program decreases hospital readmissions and length of stay (LOS) in COPD patients post-AECOPD.
• To assess the impact of a multidisciplinary intervention on COPD patient outcomes.
• To determine the effectiveness of individualized care plans in COPD management.

Main Methods:

• RCT involving 180 patients discharged after AECOPD, randomized to an intervention group (IG) or usual care (UG).
• IG received a 1-year individualized care plan: respiratory nurse education, physiotherapy, regular phone calls, and specialist clinic follow-ups.
• UG received standard care. Primary outcome: hospital readmission rate at 12 months.

Main Results:

• The IG showed a significantly reduced adjusted relative risk of readmission (0.668, p=0.047) at 12 months compared to the UG.
• The IG experienced a shorter LOS (4.59 vs 8.86 days, p≤0.001).
• Significant improvements were observed in the IG for dyspnea (mMRC scale) and quality of life (St George's Respiratory Questionnaire).

Conclusions:

• A comprehensive, multidisciplinary COPD care program effectively reduces hospital readmissions and LOS.
• The program leads to improved symptom control and enhanced quality of life for COPD patients.
• This approach represents a valuable strategy for managing COPD patients after hospital discharge.