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Improving Chronic Obstructive Pulmonary Disease (COPD) Symptoms Using a Team-Based Approach
Shaylee Peckens1, Megan M Adelman1, Amie M Ashcraft2
1From the Department of Family Medicine, West Virginia University School of Medicine, Robert C. Byrd Health Sciences Center, Morgantown (SP, MMA, AMA, JX, DEK); School of Pharmacy, West Virginia University School of Medicine, Robert C. Byrd Health Sciences Center, Morgantown (MMA, BS).
Insights
An interdisciplinary COPD specialty clinic significantly reduced hospitalizations and emergency department visits for patients in West Virginia. The clinic also improved COPD symptoms and reduced smoking rates.
Area of Science:
- Pulmonary Medicine
- Healthcare Management
- Public Health
Background:
- Chronic obstructive pulmonary disease (COPD) is a leading cause of death in the US, with West Virginia facing a high burden.
- Managing complex COPD cases is challenging within standard primary care provider visits.
- Individualized pharmacological treatment is crucial for COPD management.
Purpose of the Study:
- To evaluate the effectiveness of an interdisciplinary COPD specialty clinic.
- To assess the impact of the clinic on patient hospitalizations, emergency department (ED) visits, and urgent care visits.
- To examine the clinic's effect on nicotine dependency, COPD symptoms, and tobacco use.
Main Methods:
- Retrospective chart review of 149 patients referred to the West Virginia University Department of Family Medicine's COPD specialty clinic.
- Analysis of patient data from February 2015 to February 2019.
- Comparison of healthcare utilization and patient-reported outcomes six months and one year before and after clinic initiation.
Main Results:
- Significant reductions in hospital admissions and ED visits were observed post-clinic initiation compared to pre-clinic.
- Patients reported smoking significantly fewer cigarettes per day.
- A significant decrease in self-identified smokers and reduced COPD symptoms were reported.
Conclusions:
- An interdisciplinary, team-based approach is effective in improving health outcomes for COPD patients.
- The COPD specialty clinic model demonstrates success in an academic primary care setting.
- This approach addresses the high burden of COPD in the Appalachian region.
Background:
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States (US), with West Virginia bearing a disproportionate disease burden. Complex COPD cases can be difficult to manage during a standard primary care provider (PCP) visit, and pharmacological treatment regimens should be individually tailored to each patient.
Methods:
To address these needs, the West Virginia University Department of Family Medicine created an interdisciplinary COPD specialty clinic that uses a team-based approach to treat patients with COPD. In order to evaluate the effectiveness of the specialty clinic, we conducted a retrospective chart review to examine the impact of the clinic on patient hospitalizations, emergency department visits, and urgent care visits six months and one year before and after initiating care at the clinic. We also examined the impact of the clinic on patients' self-reported nicotine dependency, COPD symptoms, and tobacco use behavior. Patients referred to the clinic and having at least one visit from February 2015 to February 2019 were included in this study (n = 149).
Results:
Patients treated at the COPD specialty clinic had significantly fewer hospital admissions and ED visits six months after and one year after initiating care at the clinic as compared to six months before and one year before, respectively. Patients at this clinic also reported smoking significantly fewer cigarettes per day with significantly fewer self-identifying as smokers and experiencing significantly reduced COPD symptoms.
Conclusion:
An interdisciplinary, team-based approach was effective for improving the health of COPD patients in an Appalachian academic primary care practice.
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