Abstract
Introduction: Our specialist multidisciplinary respiratory team (MDRT) can successfully support COPD patients following AECOPD admission (>1000 bed-days saved/year). Patient-dependency has made discharge difficult. The aim of this pilot was to determine the efficacy/suitability of a time-limited (6/12) support program, focused on self-management.
Method: Patients admitted with AECOPD >2/year or first time with no previous diagnosis/education, were referred. Disease severity, anxiety/depression and admission frequency (year before/year after) were documented. A pre-determined program of self-management skills was assessed by the Bristol Questionaire (BQ).
Results: 23 COPD patients, (mean (±SD) age 73.3±0.02 years; FEV1 0.79±0.07; MRCDS 4.1±0.1) were under MDRT for 6.4±0.9 months (mean±SE). 11/23 were discharged appropriately; 2 died; 8/23 required ongoing support. There was no significant difference in disease severity or HADS between those discharged and those requiring ongoing support. Admission rate significantly (p<0.02) decreased from 1.9±0.2/patient in 12/12 prior to MDRT to 1.2±0.3/patient in 12/12 after team input, in both groups with no significant difference in final BQ (39.3±3.9, n=14) scores.
Conclusion: A time-limited program focused on self management is appropriate for about 50% patients admitted with severe COPD. Further work needs to be done to determine specific factors that can predict which patients are suitable for this intervention.
- © 2011 ERS
