How different measures of cold weather affect chronic obstructive pulmonary disease (COPD) hospital admissions in London

The prevalence of chronic obstructive pulmonary disease (COPD) is rising faster in women in some countries. An observational time trends study was performed to assess the evolution of hospital admissions for COPD in men and women in Spain from 1998 to 2018. ICD-9 diagnostic codes (490–492, 496) from the minimum basic data set of hospital discharges were used. Age-standardised admission rates were calculated using the European Standard Population. Joinpoint regression models were fitted to estimate the annual percent change (APC). In 2018, the age-standardised admission rate per 100,000 population/year for COPD was five times higher in men (384.8, 95% CI: 381.7, 387.9) than in women (78.6, 95% CI: 77.4, 79.9). The average annual percent change (AAPC) was negative over the whole study period in men (−1.7%/year, 95% CI: −3.1, −0.2) but positive from 2010 to 2018 (1.1%/year, 95% CI: −0.8, 2.9). In women, the APC was −6.0% (95%CI: −7.1, −4.9) from 1998 to 2010, but the trend reversed direction in the 2010–2018 period (7.8%/year, 95% CI: 5.5, 10.2). Thus, admission rates for COPD decreased from 1998 to 2010 in both men and women but started rising again until 2018, modestly in men and sharply in women.

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Impact of community-based chronic obstructive pulmonary disease service, a multidisciplinary intervention in an area of high deprivation: a longitudinal matched controlled study

BMJ Open ◽

10.1136/bmjopen-2019-032931 ◽

2020 ◽

Vol 10 (5) ◽

pp. e032931

Author(s):

Pooja Saini ◽

Tanith Rose ◽

Jennifer Downing ◽

Bashir Matata ◽

Samantha Pilsworth ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Hospital Admissions ◽

Controlled Study ◽

Control Group ◽

Chronic Obstructive ◽

Community Based ◽

Obstructive Pulmonary Disease ◽

Emergency Hospital ◽

Emergency Hospital Admissions

ObjectiveTo examine the effects of a consultant-led, community-based chronic obstructive pulmonary disease (COPD) service, based in a highly deprived area on emergency hospital admissions.DesignA longitudinal matched controlled study using difference-in-differences analysis to compare the change in outcomes in the intervention population to a matched comparison population, 5 years before and after implementation.SettingA deprived district in the North West of England between 2005 and 2016.InterventionA community-based, consultant-led COPD service providing diagnostics, treatment and rehabilitation from 2011 to 2016.Main outcome measuresEmergency hospital admissions, length of stay per emergency admission and emergency readmissions for COPD.ResultsThe intervention was associated with 24 fewer emergency COPD admissions per 100 000 population per year (95% CI −10.6 to 58.8, p=0.17) in the postintervention period, relative to the control group. There were significantly fewer emergency admissions in populations with medium levels of deprivation (64 per 100 000 per year; 95% CI 1.8 to 126.9) and among men (60 per 100 000 per year; 95% CI 12.3 to 107.3).ConclusionWe found limited evidence that the service reduced emergency hospital admissions, after an initial decline the effect was not sustained. The service, however, may have been more effective in some subgroups.

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Significant reduction in hospital admissions for acute exacerbation of chronic obstructive pulmonary disease in Hong Kong during coronavirus disease 2019 pandemic

Respiratory Medicine ◽

10.1016/j.rmed.2020.106085 ◽

2020 ◽

Vol 171 ◽

pp. 106085 ◽

Cited By ~ 5

Author(s):

King Pui Florence Chan ◽

Ting Fung Ma ◽

Wang Chun Kwok ◽

Jackson Ka Chun Leung ◽

Ka Yan Chiang ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Hong Kong ◽

Pulmonary Disease ◽

Acute Exacerbation ◽

Hospital Admissions ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease

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Factors Associated with Hospital Admission in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in a Teaching Hospital

TAJ Journal of Teachers Association ◽

10.3329/taj.v28i2.39079 ◽

2018 ◽

Vol 28 (2) ◽

pp. 52-57

Author(s):

Md Nure Alom Siddiqui ◽

Shahnaj Sultana ◽

MMR Khan ◽

PM Basak

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Hospital Admissions ◽

Forced Expiratory Volume ◽

Chronic Obstructive ◽

Related Factors ◽

Obstructive Pulmonary Disease ◽

Factors Associated ◽

Acute Exacerbations

Background: Acute exacerbations of chronic obstructive pulmonary disease (AE-COPD) impair quality of life (QOL), accelerate the decline in lung function and often require hospitalization, and thus, leading to increased healthcare burden. By identifying factors that may be associated with AE-COPD and managing them rationally, not only the hospital admissions could be avoided but progression of the disease may also be slowed.Objective. The aim of the present study was to determine the factors associated with hospital admissions among adults with AE-COPD.Methods. Seventy-three patients admitted with AE-COPD were administered a structured questionnaire during their hospital stay. Data on body mass index (BMI), smoking, symptoms, co-morbidities course of the disease, spirometry management and outcomes during the hospitalisation were obtained. Factors associated with hospital admissions were analyzed.Results. The hospitalization due to AE-COPD was significantly associated with the reduced forced expiratory volume in one second (FEV1), and peak expiratory flow rates, increasing sputum purulence, number of hospitalizations during previous year for COPD and presence of co-morbidities.Conclusions. The study shows that both disease and healthcare-related factors are predictors for hospitalisation. Identification of risk factors and appropriate management may reduce hospitalisation due to AE-COPD.TAJ 2015; 28(2): 52-57

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Análise da Revisão Cochrane: Uso de Corticoterapia Sistémica nas Exacerbações Agudas da Doença Pulmonar Obstrutiva Crónica. Cochrane Database Syst Rev. 2014,9:CD001288

Acta Médica Portuguesa ◽

10.20344/amp.5873 ◽

2014 ◽

Vol 27 (5) ◽

pp. 537

Author(s):

Pedro Azevedo ◽

João Costa ◽

António Vaz-Carneiro

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Lung Function ◽

Treatment Failure ◽

Pulmonary Disease ◽

Hospital Admissions ◽

Cochrane Review ◽

Forced Expiratory Volume ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Early Improvement

Acute exacerbations of chronic obstructive pulmonary disease are a major cause of hospital admissions and mortality, contributing to the decline in lung function, exercise capacity and quality of life. Infections are the major cause of exacerbations and treatment includes antibiotics, bronchodilators and systemic corticosteroids as anti- inflammatory agents. This Cochrane review compared: 1. use of oral and parenteral corticosteroids with placebo use; 2. routes of administration among themselves. The results indicate that there is evidence for the use of corticosteroids in the treatment of chronic obstructive pulmonary disease exacerbations since early improvement in lung function [assessed by forced expiratory volume in one second (FEV1)] has been noted, the likelihood of treatment failure and relapse in the first month has been reduced and it shortens the hospital stay in patients who do not require intensive care regimen. However, corticosteroid therapy causes an increase in adverse effects associated with drug, namely hyperglycaemia, especially if the route of administration is parenteral. Parenteral route has not shown to be superior to oral route in treatment failure, relapse, or death. Mortality up to 30 days does not seem to be affected by the use of corticosteroids. Keywords: Adrenal Cortex Hormones; Pulmonary Disease, Chronic Obstructive /drug therapy; Pulmonary Disease, Chronic Obstructive/ complications; Randomized Controlled Trials as Topic.

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Chronic obstructive pulmonary disease hospital admissions and drugs—unexpected positive associations: a retrospective general practice cohort study

npj Primary Care Respiratory Medicine ◽

10.1038/npjpcrm.2014.6 ◽

2014 ◽

Vol 24 (1) ◽

Cited By ~ 8

Author(s):

Timothy H Harries ◽

Paul T Seed ◽

Simon Jones ◽

Peter Schofield ◽

Patrick White

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

General Practice ◽

Cohort Study ◽

Pulmonary Disease ◽

Hospital Admissions ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Disease Hospital

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Performance of web-based self-care compared to multidisciplinary monitoring when managing heart failure (HF) and chronic obstructive pulmonary disease (COPD)

European Journal for Person Centered Healthcare ◽

10.5750/ejpch.v6i4.1538 ◽

2018 ◽

Vol 6 (4) ◽

pp. 526

Author(s):

Eñaut Agirre ◽

Naiara Perez ◽

Iratxe Urreta ◽

Isabel Huerta ◽

Ander Berroeta ◽

...

Keyword(s):

Heart Failure ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Hospital Admissions ◽

Self Care ◽

Chronic Obstructive ◽

Historical Cohort ◽

Care Programme ◽

Obstructive Pulmonary Disease ◽

Web Based

Rationale: The Personalised Multidisciplinary Care Programme (PMCC) in operation at Donostia University Hospital since 2009 for patients suffering from Heart Failure (HF) and/or Chronic Obstructive Pulmonary Disease (COPD) has helped to cut down the number of re-admissions and visits to the emergency department (ED), at the expense of increasing the number of consultations and telephone calls.Objectives: To compare whether a web-based self-care programme (WSC group) can maintain the same standard as that found in the PMCC programme, while reducing the number of times patients needed to contact professionals (consultations and calls). Methods: Randomised clinical trials with concealment of the randomised sequence, not blind, involving 100 patients recruited from a historical cohort study (PMCC study participants) and monitored for one year (from May 2014 to May 2015). Mortality rates, the number of visits to the ED and hospital admissions in relation to the process, the number of telephone calls and consultations and quality of life (QoL) were measured using EuroQol while patients were a part of the study.Results: No significant statistical differences were observed in terms of mortality, visits to the ED and hospital admissions between the comparison groups. More in-person consultations and calls from nurses to patients were registered with the PMCC group, as expected as this was part of the procedure.Conclusion: A self-care web can be an effective and useful tool when managing chronic diseases in re-admitted patients, the effectiveness of which greatly depends on the patients’ preparedness and on their access to multimedia format.

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Domiciliary Nebuliser Therapy — A Valuable Option in Chronic Asthma and Chronic Obstructive Pulmonary Disease?

Scottish Medical Journal ◽

10.1177/003693309804300207 ◽

1998 ◽

Vol 43 (2) ◽

pp. 48-51 ◽

Cited By ~ 2

Author(s):

D.J. Godden ◽

A. Robertson ◽

N. Currie ◽

J.S. Legge ◽

J.A.R. Friend ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Hospital Admission ◽

Pulmonary Disease ◽

Hospital Admissions ◽

Severe Disease ◽

Structured Interview ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Technical Performance ◽

Before And After

Domiciliary nebulisers are in widespread use for patients who have severe chronic airways disease, both asthma and chronic obstructive pulmonary disease (COPD). We report a study of the use of domiciliary nebulisers designed to assess practical problems and the value of such therapy in preventing hospital admissions. A total of 405 patients underwent a structured interview at home and their case records were reviewed. Technical performance of the nebuliser compressors was assessed The mean (SD) age of those interviewed was 64.5 (12) years. 185 patients had a physician diagnosis of asthma, and 208 had COPD. 87% patients used their nebuliser at least once daily. Side effects, reported by 54%, were related to frequency of use and commoner in younger patients. 29 subjects (7%) died within 2 years of receiving their nebuliser. Among the survivors, the 2 year periods before and after supply of the nebuliser were compared The percentage of patients requiring hospital admission for exacerbations of lung disease fell from 56% to 46% (p<0.01) but the number and duration of admissions was unchanged Those whose admission duration increased had more severely impaired spirometry when the nebuliser was supplied and had lower activity scores and higher breathlessness scores at the time of interview indicating more severe disease. Approximately half of the compressors were malfunctioning and patients' understanding of the principles of nebuliser treatment was poor. The provision of domiciliary nebuliser can influence hospital admission inpatients with obstructive airways disease. There is also a need for improved patient education and for technical support which may require the development of a nurse-run nebuliser service.

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