Hospital discharge protocol for patients with chronic obstructive pulmonary disease: expert consensus from India

Area of Science:

• Pulmonary Medicine and Cardiology
• Public Health in India

Background:

• Chronic obstructive pulmonary disorder (COPD) poses a significant health burden in India, characterized by frequent exacerbations leading to hospitalizations, increased healthcare costs, and mortality.
• Preventing COPD exacerbations is vital for slowing disease progression, as each event diminishes lung function and elevates future exacerbation risk.
• Evidence supports the use of discharge care bundles to reduce hospital readmissions and enhance patient outcomes in severe COPD.

Purpose of the Study:

• To identify unmet needs in managing COPD exacerbations, with a focus on discharge protocols.
• To develop recommendations for a standardized COPD discharge protocol tailored for implementation in India.

Main Methods:

• A virtual advisory board meeting was conducted with 7 leading pulmonary and cardiology experts in June 2024.
• Targeted literature searches were performed on MEDLINE, focusing on COPD post-exacerbation discharge protocols, implementation challenges, and identified gaps.

Main Results:

• Experts proposed a standardized COPD discharge protocol based on Indian clinical practices for consistent application across healthcare settings.
• Key recommendations include prioritizing accessible interventions such as smoking cessation, patient/caregiver education, medication reconciliation, and home-based pulmonary rehabilitation referrals.

Conclusions:

• A standardized, evidence-based discharge protocol is essential for managing COPD exacerbations in India.
• Prioritizing accessible and affordable interventions within discharge protocols can significantly improve patient outcomes and reduce healthcare utilization.