P105 EFFECT OF A CASE MANAGEMENT STUDY ON PRIMARY CARE USE AND PRESCRIBING FOR AECOPD

¹S. M. Jones, ¹P. Albert, ¹C. J. Warburton, ²P. M. A. Calverley, ¹L. Davies. ¹University Hospital Aintree, Liverpool, UK, ²University of Liverpool, Liverpool, UK

Introduction Case management for chronic diseases is now common across the UK. We investigated the effect on primary care use and prescribing of an intensive case management programme following hospitalisation with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

Method Patients admitted to hospital with an exacerbation of COPD were invited to participate in a randomised controlled trial of case management targeting readmissions. Patients participating in the intervention arm had intensive case management (including hospital and home visits), exercise, education and access to support 7 days a week (phone line) and nurse/doctor review 5 days a week. Controls had usual care. Data on all GP and practice nurse visits to either surgery or home and prescriptions for antibiotics and steroids (including all primary and secondary care prescriptions) were collected during the 12-month study period.

Results 107 patients participated in the study, mean (SD) age 71 (8), forced expiratory volume in 1 s (FEV₁) 0.94 (0.33) l and median (IQR) BODE score 8 (6, 9). The intervention arm contained 71 participants and 36 controls. Primary care data were available for 65 and 34 respectively and there …