Recommendations for Improving Discharge-Related Care Following a COPD Exacerbation: An Expert Panel Consensus with...

Area of Science:

• Pulmonology
• Healthcare Management
• Public Health

Background:

• Chronic obstructive pulmonary disease (COPD) exacerbations impose significant burdens globally, particularly in low- and middle-income countries (LMICs).
• Existing evidence-based recommendations for COPD exacerbation discharge are not consistently implemented in clinical practice.
• Gaps in post-discharge care and healthcare system inefficiencies hinder optimal patient outcomes.

Purpose of the Study:

• To address gaps in COPD care following exacerbations by formulating an evidence-based hospital discharge protocol.
• To focus recommendations on improving care in LMICs and reducing the burden of exacerbations.
• To enhance patient management and reduce hospital readmission rates.

Main Methods:

• Convening an advisory board of 13 international pulmonologists in September 2022.
• Reviewing available clinical evidence and conducting an online survey with pre-meeting and in-meeting questions.
• Formulating a protocol as part of a disease management program with an interdisciplinary approach and care bundle.

Main Results:

• Identified key unmet needs: poor protocol integration, inconsistent post-discharge care, and inefficient healthcare systems.
• Developed a protocol to assess readmission risk and optimize maintenance treatment based on symptoms and exacerbation risk.
• Emphasized personalized treatment plans and specialist referral for holistic post-discharge care.

Conclusions:

• A standardized, evidence-based discharge protocol is crucial for managing COPD exacerbations, especially in resource-limited settings.
• Implementation requires tailoring to local contexts, feasibility studies, standardized pathways, and stakeholder engagement.
• This approach can alleviate the burden of COPD exacerbations and improve patient outcomes through optimized discharge and follow-up care.