Early discharge care with ongoing follow-up support may reduce hospital readmissions in COPD

Figures & data

Table 1 Knowledge of COPD assessment. List of topics related to COPD discussed with each patient at their 6 week follow up visit. Patients who demonstrated an understanding of all topics on the list were included for self management education

Topics	Comment	Topics	Comments
Dirty sputum		Inhalers
Increased cough		Nebulizers
Increased SOB		Smoking Cessation
Increased wheeze		Role of exercise
Chest tightness		Relaxation
Decrease in ADL		Vaccines
Antibiotics		Avoidance measures
Steroids		Emergency
Patient understands all topics
Yes ^□
No ^□

Abbreviations: ADL, activities of daily living; COPD, chronic obstructive pulmonary disease; SOB, shortness of breath.

Table 2 Clinical characteristics of patients included in the early discharge programme and the subset that received self-management education. There were no significant differences between the two groups. Values are shown as mean ± SD

	Early discharge programme	Self-management education
N	246	60
Age	67 ± 9	69 ± 9
FEV1%	50.7 ± 20.8	50 ± 21.6
FEV1/FVC	53.2 ± 13.8	50.1 ± 13.6
TLCO%	52.0 ± 18.7	53.8 ± 19.3

Abbreviations: FEV₁, forced expiratory volume in one second; FVC, forced vital capacity; TLCO, functional test for measuring the diffusing capacity of the lungs for carbon monoxide.

Table 3 Comparisons of admissions and emergency department presentations in the 6 month and 1 year period before and after the early discharge programme. Values are shown as medians and interquartile ranges (IQR)

	12 months before early discharge	6 months before early discharge	6 months post-early discharge	12 months post-early discharge
N	246	246	239	226
Total Admissions	462	359	173	264
Rate per patient	1.88	1.45	0.72	1.16
Median (IQR) admissions per patient	1 (1,2)	1 (1,2)	0 (0,1)*	0 (0,2)†
Emergency dept presentations	523	401	208	309
Emergency dept presentations per patient	2.1	1.63	0.87	1.36
Median (IQR) emergency dept presentations per patient	1 (1,3)	1 (1,2)	0 (0,1) *	0 (0,2)†

* Notes: p < 0.001 compared to 6 months prior to early discharge;

† p < 0.001 compared to 1 year prior to early discharge.

Table 4 Comparisons of admissions and emergency department presentations in the 6 month and 1 year period before and after the early discharge programme for those patients receiving additional formal self-management education. Values are shown as median and interquartile ranges (IQR)

	12 months before early discharge	6 months before early discharge	6 months post-early discharge	12 months post-early discharge
N	60	60	60	60
Admissions	98	84	26	37
Admission rate per patient	1.63	1.4	0.43	0.61
Median (IQR) admissions per patient	1 (1,2)	1 (1,2)	0 (0,1)*	0 (0,1)†
Emergency dept presentations	107	91	34	41
Emergency dept presentations per patient	1.78	1.51	0.56	0.68
Median (IQR) emergency dept presentations per patient	1 (1,2)	1 (1,2)	0 (0,1)*	0 (0,1)†

* Notes: p < 0.001 compared to 6 months prior to early discharge;

† p < 0.001 compared to 1 year prior to early discharge.

Table 5 Comparisons of admissions in the 6 month and 1 year period before and after admission for COPD for those patients admitted in 2004 but not included in the respiratory outreach programme. Values are shown as median and interquartile range (IQR)

	12 months before admission	6 months before admission	6 months before admission	12 months before admission
N	267	267	259	244
Admissions	139	70	103	165
Median (IQR) admissions per patient	0 (0,1)	0 (0,0)	0 (0,1)*	0 (0,1)†

* Notes: p < 0.05 compared to 6 months prior to early discharge, but showing a significant increase in admissions;

† p = 0.102 compared to 1 year prior to early discharge.