Patient and Health Care Provider Perspectives on Potential Preventability of Hospital Admission for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Qualitative Study

Figures & data

Table 1 Interview Topics Protocol

Topics Regarding the Potential Preventability of Hospital Admission for AECOPD	Patient	HCP
Course of disease before hospital admission	x	x
Cause of AECOPD and hospitalisation	x	x
Patient factors - preventability	x	x
Caregiver factors - preventability	x	x
COPD and treatment knowledge	x
Self-management and patient needs	x	x
Medication adherence and technique	x	x

Abbreviations: AECOPD, acute exacerbation of COPD; HCP, health care provider.

Table 2 Patient Characteristics

Participant	1	2	3	4	5	6	7	8	9	10	11
Gender	F	M	F	F	F	M	M	F	M	M	M
Age (in years)	70	79	86	63	53	79	67	78	75	72	66
GOLD score (I–IV)	IV	IV	II	IV	III	IV	IV	III	IV	III	IV
Smoking status (pack years)	ES (41)	S (46)	ES (47)	S (58)	S (48)	ES (23)	ES (22)	ES (34)	ES (47)	S (87)	ES (63)
No. prescribed drugs*	20	14	11	3	20	19	16	15	16	14	18
No. comorbidities	1	4	2	0	3	2	0	2	0	3	2
No. AECOPD in the past year**	10	2	0	0	0	6	2	3	5	1	2
No. hospital admissions for AECOPD in the past year	6	1	0	0	0	0	2	0	4	0	0
FEV1 predicted (%)	29	22	67	24	47	48	25	71	24	31	49
FEV1/FVC (%)	34	28	39	33	58	51	27	54	33	25	65

Notes: *Daily or weekly use, including inhalation medication. **Number of oral corticosteroid prescriptions.

Abbreviations: F, Female; M, Male; S, Smoker; ES, Ex-smoker; AECOPD, acute exacerbation of COPD; FEV1, forced expiratory volume in 1 second.

Figure 1 Participant selection.

Table 3 Beliefs About Medicine Questionnaire (BMQ) Scores

Participant	BMQ General		BMQ Specific
	Harm (Range 4–20)	Overuse (Range 4–20)	Necessity (Range 5–25)	Concern (Range 5–25)
1	12	16	24	10
2	8	9	17	17
3	5	14	22	10
4	6	16	20	13
5	8	8	19	12
6	13	13	23	20
7	11	12	24	17
8	11	15	23	24
9	13	14	16	20
10	11	10	20	12
11	8	6	15	12
Mean (SD)	9.6 (2.8)	12.1 (3.4)	20.3 (3.2)	15.2 (4.7)

Table 4 Answer to Whether Te AECOPD Hospital Admission Was Preventable

	Yes	No
Patients	3	8*
Pulmonologists	1	9
HCPs ‘ward’	7	4

Notes: *Patients who thought they did not have enough knowledge to judge whether the hospital admission could have been avoided or not, were scored as not preventable.

Abbreviation: AECOPD, acute exacerbation of COPD.

Table 5 Agreement of Perspectives About Potential Preventability of the Patient’s Hospital Admission for AECOPD

			Pulmonologist			Kappa
			Yes	No		−0.18 [95% CI: −0.46–0.11]
Patient		Yes	0	3
		No	1	6
			HCP “ward”			Kappa
			Yes	No		−0.28 [95% CI:-0.80–0.21]
Patient		Yes	1	2
		No	6	2
			HCP “ward”			Kappa
			Yes	No		0.14 [95% CI:-0.13–0.41]
Pulmonologist		Yes	1	0
		No	5	4

Abbreviations: AECOPD, acute exacerbation of COPD; CI, confidence interval.