The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts


Brian W. Carlin1, Kim Wiles2, Dan Easley2, Nan Rees3; 1Allegheny General Hospital, Pittsburgh, PA; 2Klingensmith HealthCare, Ford City, PA; 3St. Clair Hospital, Pittsburgh, PA

Background: Appropriate medication use is an important component in the management of a patient with COPD following a hospitalization for an exacerbation. Readmission rates may depend upon the actual medications being used. Objective: To evaluate the medication usage in patients with COPD who were readmitted to the hospital following discharge for treatment of an exacerbation. Method: The Discharge, Assessment and Summary at Home (D.A.S.H., Klingensmith HealthCare) program was implemented for patients who require supplemental oxygen use following hospital admission and has been previously described in detail. For those patients who were readmitted to the hospital within the first 30 days following discharge, analysis of the respiratory medications being used was done. Medication usage was obtained directly from the patient by the respiratory therapist who was visiting the patient in the home on the day following hospital discharge. Medications were classified based upon the following: metered dose inhaler (MDI), long acting beta agonist (LABA), long acting muscarinic agent (LAMA), inhaled corticosteroid (ICS), oral corticosteroid (OCS), antibiotic (ATB), aerosol (beta agonist and/or muscarinic), or leukotriene modifier (LTM). Three hundred and one patients with COPD from 23 different hospitals were studied. Results: 14 of the 301 (5%) patients in the DASH program were readmitted within the first 30 days following discharge. The following medications/combinations were being used (Table 1). 4/14 (28%) were receiving an MDI or ICS only of which two patients were on no therapy. Only 1/14 (7%) was receiving an oral corticosteroid and 0/14 (0%) were receiving an antibiotic. 8/14 (57%) patients were on a combination that included LAMA and/or LABA, and an ICS and/or OCS. 2/14 (14%) were on a LAMA alone. Conclusions: In this COPD patient population who required rehospitalization within 30 days of hospital discharge, 28% of patients failed to be prescribed therapy that has been shown to reduce exacerbations. Variable usage patterns in this patient population exist. More well-defined guidelines regarding such therapy should be developed and implementation encouraged
Sponsored Research - Klingensmith HealthCare developed the program. Kim Wiles and Dan Easley are employees of Klingensmith HealthCare. Dr. Carlin and Ms. Rees have no financial interests in Klingensmith HealthCare.