Abstract
Background: The high health care utilization of many patients with advanced COPD may reflect sub-optimal preparation of the patient and caregiver to effectively manage COPD upon discharge.
Purpose: To examine the assessments of COPD patients and their caregivers regarding care transition quality within two weeks of discharge from hospital.
Design: This cross-sectional study included 22 dyads (N=44) of patients with advanced COPD (MRC 3, 4 or 5) and their caregivers in two Canadian cities. The Care Transitions Measure (CTM-15) was used to obtain scores from both the patients and caregiver on the quality of care transition. CTM-15 scores range from 0-100, with higher scores indicating higher quality of care transition. Correlations between CTM-15 scores, global rating of health and the Clinical COPD Questionnaire (CCQ) were assessed.
Results: Median CTM-15 score for patients was 58.9 (IQR= 30.5) compared with 46.7 (IQR= 16.5) for caregivers (NS). The majority of patients did not have clear health goals upon discharge (63.6%) a written plan of care (59.1%). Caregivers did not understand warning signs and symptoms to monitor (72.7%), understand how to manage the patient's health (68.2%) or have all the information needed to be able to take care of the patient upon discharge (54.5%). CTM-15 scores were negatively correlated with CCQ scores (p=0.04) but not with global rating of health.
Interpretation: COPD patients and their caregivers require additional preparation for discharge and reported important gaps that have important implications for self-care in the community. CTM-15 scores in this study were lower than those previously reported in geriatric literature.
- © 2011 ERS