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Can a supported self-management program for COPD upon hospital discharge reduce readmissions? A randomized controlled trial
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Singh, Sally, Rees, Karen, Gelder, Colin, Morgan, Mike and Johnson-Warrington, Vicki (2016) Can a supported self-management program for COPD upon hospital discharge reduce readmissions? A randomized controlled trial. International Journal of Chronic Obstructive Pulmonary Disease, 11 (1). pp. 1161-1169. doi:10.2147/COPD.S91253 ISSN 1178-2005.
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Official URL: http://dx.doi.org/10.2147/COPD.S91253
Abstract
Introduction: Patients with COPD experience exacerbations that may require hospitalization. Patients do not always feel supported upon discharge and frequently get readmitted. A Self-management Program of Activity, Coping, and Education for COPD (SPACE for COPD), a brief self-management program, may help address this issue.
Objective: To investigate if SPACE for COPD employed upon hospital discharge would reduce readmission rates at 3 months, compared with usual care.
Methods: This is a prospective, single-blinded, two-center trial (ISRCTN84599369) with participants admitted for an exacerbation, randomized to usual care or SPACE for COPD. Measures, including health-related quality of life and exercise capacity, were taken at baseline (hospital discharge) and at 3 months. The primary outcome measure was respiratory readmission at 3 months.
Results: Seventy-eight patients were recruited (n=39 to both groups). No differences were found in readmission rates or mortality at 3 months between the groups. Ten control patients were readmitted within 30 days compared to five patients in the intervention group (P>0.05). Both groups significantly improved their exercise tolerance and Chronic Respiratory Questionnaire (CRQ-SR) results, with between-group differences approaching statistical significance for CRQ-dyspnea and CRQ-emotion, in favor of the intervention. The “Ready for Home” survey revealed that patients receiving the intervention reported feeling better able to arrange their life to cope with COPD, knew when to seek help about feeling unwell, and more often took their medications as prescribed, compared to usual care (P<0.05).
Conclusion: SPACE for COPD did not reduce readmission rates at 3 months above that of usual care. However, encouraging results were seen in secondary outcomes for those receiving the intervention. Importantly, SPACE for COPD appears to be safe and may help prevent readmission with 30 days.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > RC Internal medicine | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Statistics and Epidemiology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Lungs -- Diseases, Obstructive -- Treatment, Emphysema, Pulmonary, Exercise therapy | ||||||
Journal or Publication Title: | International Journal of Chronic Obstructive Pulmonary Disease | ||||||
Publisher: | Dove Medical Press | ||||||
ISSN: | 1178-2005 | ||||||
Official Date: | 2 June 2016 | ||||||
Dates: |
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Volume: | 11 | ||||||
Number: | 1 | ||||||
Page Range: | pp. 1161-1169 | ||||||
DOI: | 10.2147/COPD.S91253 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Date of first compliant deposit: | 4 July 2016 | ||||||
Date of first compliant Open Access: | 4 July 2016 | ||||||
Funder: | British Lung Foundation |
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