The relationship between self-management abilities, quality of chronic care delivery, and wellbeing among patients with chronic obstructive pulmonary disease in The Netherlands

40 elderly and senile patients were examined including 20 patients with exacerbation of chronic obstructive pulmonary disease (COPD) of moderate severity (experimental group) and 20 cases without COPD, acute diseases and exacerbations of chronic pathology (control group). Impact of COPD was studied for various aspects of quality of life. It was analyzed the nature and strength of the relationship between of quality of life indicators and biochemical survey results.

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

Healthcare ◽

10.3390/healthcare9101267 ◽

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.

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The Study of Biomarkers of Systemic Inflammation in Patients with Chronic Obstructive Pulmonary Disease in the Relationship with the Severity of Shortness of Breath and Indicators of the Quality of Life of Patients

Family Medicine ◽

10.30841/2307-5112.5-6.2019.194300 ◽

2019 ◽

Vol 0 (5-6) ◽

pp. 105-108

Author(s):

Бен Аммар Сауссен ◽

О. С. Коміссарова ◽

Н. В. Кіча ◽

Л. В. Черкашина

Keyword(s):

Quality Of Life ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Systemic Inflammation ◽

Chronic Obstructive ◽

Shortness Of Breath ◽

Obstructive Pulmonary Disease ◽

The Relationship

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Resilience as a Mediator of the Association between Spirituality and Self-Management among Older People with Chronic Obstructive Pulmonary Disease

Healthcare ◽

10.3390/healthcare9121631 ◽

2021 ◽

Vol 9 (12) ◽

pp. 1631

Author(s):

Zhongyi Chen ◽

Yuyu Jiang ◽

Mengjie Chen ◽

Nuerdawulieti Baiyila ◽

Jiang Nan

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Older People ◽

Pulmonary Disease ◽

Statistical Significance ◽

Mediating Effect ◽

Self Management ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Management Interventions ◽

The Relationship

This study examined the mediating effect of resilience in the relationship between spirituality and self-management among older people with chronic obstructive pulmonary disease (COPD). The participants were 151 older people with COPD in four general hospitals in Jiangsu Province, China. Data were collected from September 2020 to May 2021 using a questionnaire developed by the investigator, the Function Assessment of Chronic Illness Therapy-Spiritual Scale (FACIT-SP-12), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and COPD Self-Management Scale (CSMS). One-way ANOVA and t-test were used to compare the level of self-management in patients with different sociodemographic and clinical characteristics. Partial correlation analysis was used to explore the correlation between spirituality, resilience, and self-management. Hierarchical multiple regression analyses were performed to examine the contribution of spirituality and resilience to the prediction of self-management. A bootstrapping test was implemented using the SPSS PROCESS macro to test the statistical significance of the mediating effect. There was a pairwise positive correlation between spirituality, resilience, and self-management. Resilience mediated the relationship between spirituality and self-management. These findings suggested that resilience interventions could be incorporated into future COPD self-management interventions to better improve self-management and health outcomes. Moreover, resilience should be an important component of healthy aging initiatives.

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Models of care across the continuum of exacerbations for patients with chronic obstructive pulmonary disease

Chronic Respiratory Disease ◽

10.1177/1479973119895457 ◽

2020 ◽

Vol 17 ◽

pp. 147997311989545 ◽

Cited By ~ 1

Author(s):

Jean Bourbeau ◽

Carlos Echevarria

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Models Of Care ◽

Self Management ◽

Chronic Obstructive ◽

Readmission Rates ◽

Obstructive Pulmonary Disease ◽

Management Interventions ◽

The Continuum

Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with significant morbidity and mortality, and treatments require a multidisciplinary approach to address patient needs. This review considers different models of care across the continuum of exacerbations (1) chronic care and self-management interventions with the action plan, (2) domiciliary care for severe exacerbation and the impact on readmission prevention and (3) the discharge care bundle for management beyond the acute exacerbation episode. Self-management strategies include written action plans and coaching with patient and family support. Self-management interventions facilitate the delivery of good care, can reduce exacerbations associated with admission, be cost-effective and improve quality of life. Hospitalization as a complication of exacerbation is not always unavoidable. Domiciliary care has been proposed as a solution to replace part, and perhaps even all, of the patient’s in-hospital stay, and to reduce hospital bed days, readmission rates and costs; low-risk patients can be identified using risk stratification tools. A COPD discharge bundle is another potentially important approach that can be considered to improve the management of COPD exacerbations complicated by hospital admission; it comprised treatments that have demonstrated efficacy, such as smoking cessation, personalized pharmacotherapy and non-pharmacotherapy such as pulmonary rehabilitation. COPD bundles may also improve the transition of care from the hospital to the community following exacerbation and may reduce readmission rates. Future models of care should be personalized – providing patient education aiming at behaviour changes, identifying and treating co-morbidities, and including outcomes that measure quality of care rather than focusing only on readmission quantity within 30 days.

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