Reducing the Readmission Burden of COPD: A Focused Review of Recent Interventions

Abstract The burden of chronic obstructive pulmonary disease (COPD) in the United States is high, especially with regard to readmission rates and annual cost of health care. However, to date, there is little consensus about which clinical interventions have the greatest impact on reducing COPD readmissions. We reviewed literature in PubMed/MEDLINE to identify interventions that have the greatest impact on COPD readmissions, stratified by four clinical domains: patient risk factors, longitudinal care, acute care, and post-discharge care. Patients with more severe disease and fewer social supports are most vulnerable to COPD readmission. Chronic treatment with combined inhaled corticosteroids-long-acting beta-agonists or tiotropium as well as early antibiotic treatment during acute hospitalization decrease readmission rates. After discharge, the greatest effect on readmission rates was seen with early pulmonary rehabilitation, outpatient follow-up within 30 days, and enrollment in an integrated care program. While the standard of care in reducing COPD readmission rates remains to be elucidated, a multi-faceted approach that targets high-risk populations is likely to be most effective.
Source: Current Emergency and Hospital Medicine Reports - Category: Emergency Medicine Source Type: research