Journal of the American Medical Directors Association
JAMDA OnlineOriginal StudyDischarge Coordinator Intervention Prevents Hospitalizations in Patients With COPD: A Randomized Controlled Trial
Section snippets
Study Design
For this randomized controlled clinical trial we enrolled 253 eligible patients between November 2, 2009, and December 6, 2011, from a specialized pulmonary hospital. The study design and protocol have been published previously.15 In brief, patients with acute exacerbation of COPD were randomized within 48 hours after admission to discharge coordinator intervention or care as usual. During 180 days after discharge, patients were regularly followed by phone or through direct contact. The
Study Patients
A total of 253 patients were enrolled during the recruitment period (Figure 1) and were followed for at least 180 days after discharge from hospital or until death. The clinical and sociodemographic characteristics of the patients are shown in Table 1. Enrolled patients were mostly elderly men (72%) with an average age of 71 ± 9 years, with significant smoking exposure and mostly with severe pulmonary obstruction. The 2 groups of patients were similar with respect to baseline characteristics,
Discussion
Among our hospitalized patients with COPD, discharge coordinator intervention significantly reduced both COPD hospitalizations and all-cause hospitalizations during the 180 days after discharge. The reduction in all-cause hospitalizations in the intervention group was apparently driven by reduction of COPD hospitalizations. We observed no benefits in health-related quality of life and no reduction of all-cause mortality.
Over the past decade there has been growing interest in the use
Acknowledgments
This trial was made possible through the dedication and effort of the trial personnel: Marusa Ahacic, Barbara Bukovnik, Dragica Cof, Ana Delimar, Dejan Dobersek, Natasa Grahovec, Ivanka Krzisnik, Maja Mali, Pika Mesko Brguljan, Breda Papler, Urska Papler, Katja Pilar, Irena Pocvavsek, Lojzka Prestor, Sasa Primozic, Majda Pusavec, Mojca Sarlija, Tina Starman, Alain Sumer, Katja Vrankar, Barbara Zadnik, Natasa Zizmond, and Katja Zupanc.
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How to organize hospital discharge after COPD exacerbation?
2017, Revue des Maladies RespiratoiresFollow-up after acute COPD exacerbation
2017, Revue des Maladies RespiratoiresPatient- and family-centred care transition interventions for adults: a systematic review and meta-analysis of RCTs
2023, International Journal for Quality in Health Care
Clinical trials registration: ClinicalTrials.gov - NCT0122562, No financial support was received for this trial.
The authors declare no conflicts of interest.