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Analysis of Hospitalizations for COPD Exacerbation: Opportunities for Improving Care

Authors :
Brian K. Regan
Neil W. Schluger
George Yuen
Natalie H Yip
Byron Thomashow
Liziamma George
Brian Taylor
Richard Stumacher
Marcia D. Brinson
Eliot J. Lazar
Stephen R Karbowitz
Source :
COPD: Journal of Chronic Obstructive Pulmonary Disease. 7:85-92
Publication Year :
2010
Publisher :
Informa UK Limited, 2010.

Abstract

Background: Little is known about the actual treatment of patients with chronic obstructive pulmonary disease (COPD), either in the inpatient or outpatient settings. We hypothesized that there are substantial opportunities for improvement in adherence with current guidelines and recommendations. Methods: We reviewed the medical records of all patients hospitalized with acute exacerbation of COPD between January 2005 and December 2006 at 5 New York City hospitals. Results: There were 1285 unique patients with 1653 hospitalizations. Of these 1653, 83% were for patients with a prior history of COPD and 368 (22%) represented repeat admissions during our study period. The majority were treated during their hospitalization with a combination of systemic steroids (85%), bronchodilators (94%) and antibiotics (80%). There were 59 deaths (3.6%). Smoking cessation counseling was offered to 48% of active smokers. Influenza and pneumococcal vaccines were administered to half of eligible patients. On discharge, only 46.0% were prescribed maintenance bronchodilators and 24% were not prescribed any inhaled therapy. Even in the 226 unique patients (17.6%) readmitted at least once during course of the study, on discharge only 44.7% were prescribed maintenance bronchodilators and 23% were not prescribed any regular inhaled therapy. Conclusions: Patients hospitalized with acute exacerbation of COPD generally receive adequate hospital care, but there may be opportunities to improve care pharmacologically and with smoking cessation counseling and vaccination during and after hospitalization.

Details

ISSN :
15412563 and 15412555
Volume :
7
Database :
OpenAIRE
Journal :
COPD: Journal of Chronic Obstructive Pulmonary Disease
Accession number :
edsair.doi.dedup.....d8444a20f757e129f0ef5a9803b563d1
Full Text :
https://doi.org/10.3109/15412551003631683