scholarly journals Quality of Care of Patients Hospitalized with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Retrospective Chart Review Study

2021 ◽  
Author(s):  
A. Smith-Nunez ◽  
V.G. Press ◽  
D. Lewis ◽  
S. Goyal ◽  
J.C. Rojas
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Quality Of Care ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Review Study

scholarly journals Safety and efficacy of inpatient pulmonary rehabilitation for patients hospitalised with an acute exacerbation of chronic obstructive pulmonary disease: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e043377
Author(s):  
Kai Zhu ◽  
Jagdeep Gill ◽  
Ashley Kirkham ◽  
Joel Chen ◽  
Amy Ellis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Pulmonary Rehabilitation ◽  
Meta Analysis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Safety And Efficacy

IntroductionPulmonary rehabilitation (PR) following an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) reduces the risk of hospital admissions, and improves physical function and health-related quality of life. However, the safety and efficacy of in-hospital PR during the most acute phase of an AECOPD is not well established. This paper describes the protocol for a systematic review with meta-analysis to determine the safety and efficacy of inpatient acute care PR during the hospitalisation phase.Methods and analysisMedical literature databases and registries MEDLINE, EMBASE, Physiotherapy Evidence Database, Cumulative Index to Nursing and Allied Health Literature, Canadian Agency for Drugs and Technologies in Health, CENTRAL, Allied and Complementary Medicine Database, WHO trials portal and ClinicalTrials.gov will be searched for articles from inception to June 2021 using a prespecified search strategy. We will identify randomised controlled trials that have a comparison of in-hospital PR with usual care. PR programmes had to commence during the hospitalisation and include a minimum of two sessions. Title and abstract followed by full-text screening will be conducted independently by two reviewers. A meta-analysis will be performed if there is sufficient homogeneity across selected studies or groups of studies. The Population, Intervention, Comparator, Outcomes and Study characteristics framework will be used to standardise the data collection process. The quality of the cumulative evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations framework.Ethics and disseminationAECOPD results in physical limitations which are amenable to PR. This review will assess the safety and efficacy of in-hospital PR for AECOPD. The results will be presented in a peer-reviewed publication and at research conferences. Ethical review is not required for this study.

scholarly journals Clearing heat and resolving phlegm for acute exacerbation of chronic obstructive pulmonary disease with the syndrome of phlegm-heat obstruction of the lung

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094550
Author(s):  
Jia Yang ◽  
Junchao Yang
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Large Scale ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Protein Levels ◽  
Reactive Protein

Objective This study aimed to evaluate the effect of clearing heat and resolving phlegm for acute exacerbation of chronic obstructive pulmonary disease with the syndrome of phlegm-heat obstruction of the lung. Methods This was a real-world retrospective cohort study of inpatients at our institution from 1 January 2015 to 31 December 2017. The patients were divided into two groups according to whether they received oral traditional Chinese medicine (TCM) for clearing heat and resolving phlegm or routine treatment (controls). Efficacy and safety indicators were analyzed. Propensity score matching was used to control for confounding factors. Results Among 488 patients, 164 (82 pairs) were successfully matched. The changes in neutrophils (%) and C-reactive protein levels were more significant in the TCM group than in the control group. The duration of fever was significantly shorter in the TCM group than in the control group. Conclusions The therapy of clearing heat and resolving phlegm might effectively control the inflammatory reaction of acute exacerbation of chronic obstructive pulmonary disease in patients with the syndrome of phlegm-heat obstruction of the lung, especially for those with fever. Nevertheless, large-scale and prospective studies are required to provide a higher quality of evidence.

scholarly journals Initiative to Improve Evidence-Based Chronic Obstructive Pulmonary Disease Hospitalist Care Using a Novel On-Line Gamification Patient Simulation Tool: A Prospective Study

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1267
Author(s):  
Jodi Strong ◽  
Larry Weems ◽  
Trever Burgon ◽  
Jeremy Branch ◽  
Jenny Martin ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Quality Of Care ◽  
Pulmonary Disease ◽  
Care Delivery ◽  
Patient Simulation ◽  
Simulated Patients ◽  
Chronic Obstructive ◽  
Evidence Based ◽  
Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) remains a leading cause of morbidity and mortality. Much of the disease burden comes from exacerbations requiring hospitalization. Unwarranted care variation and divergence from evidence-based COPD management guidelines among hospitalists is a leading driver of the poor outcomes and excess costs associated with COPD-related hospitalizations. We engaged with Novant Health hospitalists to determine if measurement and feedback using fixed-choice simulated patients improves evidence-based care delivery and reduces costs. We created a series of gamified acute-care COPD case simulations with real-time feedback over 16 weeks then performed a year-over-year analytic comparison of the cost, length of stay (LOS), and revisits over the six months prior to the introduction of the simulated patients, the four months while caring for the simulated patients, and the six months after. In total, 245 hospitalists from 15 facilities at Novant Health participated. At baseline, the overall quality-of-care was measured as 58.4% + 12.3%, with providers correctly identifying COPD exacerbation in 92.4% of cases but only identifying the grade and group in 61.9% and 49.5% of cases, respectively. By the study end, the quality-of-care had improved 10.5% (p < 0.001), including improvements in identifying the grade (+9.7%, p = 0.044) and group (+8.4%, p = 0.098). These improvements correlated with changes in real-world performance data, including a 19% reduction in COPD-related pharmacy costs. Overall, the annualized impact of COPD improvements led to 233 fewer inpatient days, 371 fewer revisit days, and inpatient savings totaling nearly $1 million. Engaging practicing providers with patient simulation-based serial measurements and gamified evidence-based feedback potentially reduces inpatient costs while simultaneously reducing patient LOS and revisit rates.

Quality of Care for Patients Hospitalized for Acute Exacerbations of Chronic Obstructive Pulmonary Disease

2006 ◽  
Vol 144 (12) ◽  
pp. 894 ◽  
Author(s):  
Peter K. Lindenauer ◽  
Penelope Pekow ◽  
Shan Gao ◽  
Allison S. Crawford ◽  
Benjamin Gutierrez ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Quality Of Care ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbations

Quality of care of patients with chronic obstructive pulmonary disease provided by specialized community nurses: a process evaluation

2007 ◽  
Vol 4 (4) ◽  
pp. 200-207 ◽  
Author(s):  
Corry A.J. Ketelaars ◽  
Huda Huyer Abu-Saad ◽  
Ruud J.G. Halfens ◽  
Maryanne A.G. Schlösser ◽  
Rob Mostert ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Quality Of Care ◽  
Pulmonary Disease ◽  
Process Evaluation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

scholarly journals The de Morton mobility index is a feasible and valid mobility assessment tool in hospitalized patients with an acute exacerbation of chronic obstructive pulmonary disease

2019 ◽  
Vol 16 ◽  
pp. 147997311987297 ◽  
Author(s):  
Pat G Camp ◽  
Carmen A Sima ◽  
Ashley Kirkham ◽  
Jessica A Inskip ◽  
Beena Parappilly
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Hospitalized Patients ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Mobility Index ◽  
Group Validity

There is no accepted standard for measuring mobility in hospitalized patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The objective of this study was to assess convergent, discriminant, and known-group validity and floor/ceiling effects of the de Morton Mobility Index (DEMMI) in hospitalized patients with AECOPD. Individuals with AECOPD ( n = 22) admitted to an acute care hospital medical ward were recruited. Data on the DEMMI, gait speed, daytime energy expenditure, step counts, 6-minute walk distance (6MWD), dyspnea, respiratory and heart rates, quality of life, and oxygen supplementation were collected on day 3 of admission. The DEMMI demonstrated convergent validity with the 6MWD and gait velocity measures (Spearman’s ρ 0.69 and 0.61, respectively; p < 0.003) but not with measures of physical activity or respiratory impairment. Discriminant validity was present, with no correlation between the DEMMI and quality of life and resting heart rate. Known-group validity (gait aids vs. no gait aids) was demonstrated ( p = 0.009). There was no floor effect but there was evidence of a possible ceiling effect (14% of participants received a perfect score). The DEMMI is feasible and showed moderate to strong validity with measures of observed physical function in hospitalized patients with AECOPD.

scholarly journals Protocol for an observational study to identify potential predictors of an acute exacerbation in patients with chronic obstructive pulmonary disease (the PACE Study)

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043014
Author(s):  
Klaus Kenn ◽  
Rainer Gloeckl ◽  
Daniela Leitl ◽  
Tessa Schneeberger ◽  
Inga Jarosch ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Hospital Admissions ◽  
Negative Impact ◽  
Chronic Obstructive ◽  
Detailed Knowledge ◽  
Obstructive Pulmonary Disease

IntroductionAcute exacerbations of chronic obstructive pulmonary disease (AECOPD) are the most critical events for patients with COPD that have a negative impact on patients’ quality of life, accelerate disease progression, and can result in hospital admissions and death. Although there is no distinct definition or detailed knowledge about AECOPD, it is commonly used as primary outcome in clinical studies. Furthermore, it may be difficult in clinical practice to differentiate the worsening of symptoms due to an AECOPD or to the development of heart failure. Therefore, it is of major clinical importance to investigate the underlying pathophysiology, and if possible, predictors of an AECOPD and thus to identify patients who are at high risk for developing an acute exacerbation.Methods and analysisIn total, 355 patients with COPD will be included prospectively to this study during a 3-week inpatient pulmonary rehabilitation programme at the Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee (Germany). All patients will be closely monitored from admission to discharge. Lung function, exercise tests, clinical parameters, quality of life, physical activity and symptoms will be recorded, and blood samples and exhaled air will be collected. If a patient develops an AECOPD, there will be additional comprehensive diagnostic assessments to differentiate between cardiac, pulmonary or cardiopulmonary causes of worsening. Follow-up measures will be performed at 6, 12 and 24 months.Exploratory data analyses methods will be used for the primary research question (screening and identification of possible factors to predict an AECOPD). Regression analyses and a generalised linear model with a binomial outcome (AECOPD) will be applied to test if predictors are significant.Ethics and disseminationThis study has been approved by the Ethical Committee of the Philipps University Marburg, Germany (No. 61/19). The results will be presented in conferences and published in a peer-reviewed journal.Trial registration numberNCT04140097.

Sign in / Sign up

Export Citation Format

Share Document