Article Text


COPD and drugs: new and old concepts
P261 Does the provision of a rescue pack keep patients with chronic obstructive pulmonary disease (COPD) at home?
  1. L E E Schomberg,
  2. J L Garner,
  3. J W Porter,
  4. K Bahadur,
  5. L Ross,
  6. C A Kosky,
  7. A C Davidson
  1. Guy's and St Thomas' NHS Foundation Trust, London, UK


Introduction COPD accounts for one in eight hospital admissions, 1 million bed days and costs £870–930 m a year.1 Early treatment of exacerbations with steroids reduces severity and may reduce the need for hospital admission.2 We evaluated the acceptance and use of a rescue pack provided on discharge from hospital.

Methods 38 patients, discharged between 1 February and 30 June 2011, were supplied a 7 day rescue pack comprising Prednisolone 25 mg and Doxycycline 100 mg (total cost of £7) with education and a self-management plan.

A telephone questionnaire was conducted in July:

  1. Do you remember being given a rescue pack on discharge from hospital?

  2. Have you had a flare-up of your COPD since discharge?

  3. Did you use your rescue pack?

  4. Did you take both antibiotic and steroid?

  5. Did you complete the course?

  6. Do you think it helped keep you at home?

  7. Have you got a replacement rescue pack?

Results 25 out of 38 (66%) patients were contactable. 11 (44%) were male and 14 (56%) female. The median age was 77 (range 53–89) years. The median time from discharge to telephone contact was 110 (range 21–168) days. 24 (96%) patients acknowledged receipt of the rescue pack. 14 out of 15 (93%) patients who had experienced an exacerbation of COPD had used the rescue pack. Of these 14 patients, 13 (93%) were confident of the benefit and 10 (71%) had obtained a replacement pack. Six of the 38 (16%) patients supplied with a rescue pack were re-admitted with an exacerbation.

Conclusions The results of this service evaluation suggest a cost-effective initiative that may reduce hospital re-admission by promoting earlier treatment. Rescue packs should be supported by education and a self-management plan.

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