The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

DISEASE MANAGEMENT PROGRAM FOR PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A RETROSPECTIVE OBSERVATIONAL STUDY ON PATIENT OUTCOMES

K. A. Wyka1, J. M. Green1


Background: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible and is gaining both national and global prominence as a major health problem. Disease management (DM) programs employing respiratory therapists (RTs) to design and implement such a program in terms of managing and following these patients in the home environment can result in improved patient outcomes with regard to treatment compliance, reduction in respiratory-related symptoms and fewer emergency department (ED) visits or hospitalizations.

Methods:
A retrospective observational study was conducted over a one year period of time (January 2006 – January 2007) following COPD patients (n=26, 12 males and 14 females, mean age=69.4 years) who were enrolled in a DM program versus a control group (n=15, 7 males and 8 females, mean age=70.2 years) who received home oxygen and/or nebulizer therapy but no ongoing RT follow-up visits.

Results: The study demonstrated that 22/26 patients (85%) enrolled in the DM program were compliant with prescribed home care therapy (oxygen and/or aerosolized medications), 25/26 patients (96%) experienced fewer respiratory-related symptoms (perception of dyspnea, cough/sputum production, activity level, sleep, appetite, weight management and anxiety level), 20/26 patients (77%) had no ED visits or hospitalizations during the one year study period, 4/26 patients (15%) had 1 ED visit and hospitalization and 2/26 patients (8%) had 2 or more ED visits and hospitalizations The control group had 9/15 patients (60%) compliant with prescribed home therapy, 5/15 patients (33%) experienced fewer respiratory-related symptoms, 8/15 patients (53%) had no ED visits or hospitalizations, 2/15 patients (14%) had 1 ED visit, 5/15 patients (33%) had 2 or more ED visits, 3/15 patients (20%) had 1 hospitalization and 4/15 patients (27%) had 2 or more hospitalizations.

Conclusion: Patients on respiratory home care who are also enrolled in a DM program involving RTs who provide assessment, education and therapeutic follow-up demonstrate improved outcomes with regard to treatment compliance, symptoms and number of ED visits and hospitalizations.

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