Introduction COPD is a condition with multiple implications to the sufferer in terms of disability and high mortality, and one that often necessitates multiple hospital admissions, resulting in further distress to the patient as well as increased healthcare costs. Bi-level positive airway pressure (BIPAP) has long been used to treat patients with acute exacerbations of COPD in hosiptal settings. We aim to decipher if institution of BIPAP reduces the number of hospital admissions in patients with COPD.
Method We used a regional database to gather information on patients on domicilliary BIPAP in the region, and identified the number of patients with a primary diagnosis of COPD. We then used the electronic discharge notification software in hospitals in the region to identify the number of hospital admissions in these patients before and after the institution of BIPAP, within a one-year period. We used 2011 as the base year, i.e., we collected data from patients who were initiated on BIPAP in 2011, and determined the number of admissions the year prior to, and the year following, initiation of BIPAP.
Results On the database studied, 317 patients were on domiciliary BIPAP, 112 of which were secondary to COPD (35.33% of the total database). A total of 23 patients were commenced on BIPAP in 2011. The number of admissions per year prior to initiating BIPAP ranged from 0 to 4, with a total of 39 admissions among all patients, equating to a mean of 1.70 admissions per patient. This reduced to 14 in the year following BIPAP, with an average of 0.61 admissions per patient, reducing the number of admissions by almost two-thirds.
Conclusion These findings suggest that the use of domiciliary BIPAP reduces hospital admissions in patients with COPD, thereby improving, at least partially, their quality of life. It also highlights the importance of a dedicated centre for managing patients on domiciliary BIPAP, as this database reflected the work of a single respiratory centre within the region specialising in managing patients requiring domiciliary BIPAP, thereby providing standardised care.