RT Journal Article
SR Electronic
T1 Integrated care intervention prevents hospitalisations for exacerbations and reduces the disease costs in COPD patients
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 4870
VO 38
IS Suppl 55
A1 Sara Balestracci
A1 Anna Porcu
A1 Erika Fiumalbi
A1 Mariella Polselli
A1 Fimmg Progetto Mito
A1 PierCarlo Rossi
A1 Andrea Macuzzi
A1 Maurizio Moretti
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/4870.abstract
AB Introduction: Efficacy of interventions aimed at preventing hospitalisations due to exacerbations in clinically stable COPD patients is controversial.Objectives: To evaluate usefulness of integrated care intervention (ICI) on hospital admission for exacerbations and disease costs in COPD patients.Methods: This prospective study was carried out in 208 COPD patients recruited by general practitioners between January 2009 and December 2009 in Massa-Carrara sanitary district.The interventions included individually tailored care plan following GOLD guidelines shared among the chest physician, nurse team and general practitioner, educational program on self-management of the disease, treatment supervision during scheduled visits, home visits by specialised nurses.Results: 105 patients completed 12 months of follow-up, stratified in stage 1 (n.11), stage 2 (n.47), stage 3 (n.34), stage 4 (n.13) using the GOLD classification.Twelve months of ICI decreased the mean number of hospitalisations (0.54±1.1 versus 0.82±1.1 p<0.05), reduced the percentage of hospitalised patients (27% versus 51% respectively) compared to the previous year. Gold 3 and 4 stages showed the highest reduction in hospitalisation rate. Drug-acquisition costs significantly increased (average difference in means + 256 €) while the mean total disease cost per patients decreased (-201 €) after ICI.Conclusions: The study demonstrates that a standardised ICI based on share-care intervention between primary care team and hospital team effectively prevents hospitalisations for exacerbations and decreases the total disease cost in COPD patients.