Models of care across the continuum of exacerbations for patients with chronic obstructive pulmonary disease.

Models of care across the continuum of exacerbations for patients with chronic obstructive pulmonary disease. Chron Respir Dis. 2020 Jan-Dec;17:1479973119895457 Authors: Bourbeau J, Echevarria C Abstract Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with significant morbidity and mortality, and treatments require a multidisciplinary approach to address patient needs. This review considers different models of care across the continuum of exacerbations (1) chronic care and self-management interventions with the action plan, (2) domiciliary care for severe exacerbation and the impact on readmission prevention and (3) the discharge care bundle for management beyond the acute exacerbation episode. Self-management strategies include written action plans and coaching with patient and family support. Self-management interventions facilitate the delivery of good care, can reduce exacerbations associated with admission, be cost-effective and improve quality of life. Hospitalization as a complication of exacerbation is not always unavoidable. Domiciliary care has been proposed as a solution to replace part, and perhaps even all, of the patient's in-hospital stay, and to reduce hospital bed days, readmission rates and costs; low-risk patients can be identified using risk stratification tools. A COPD discharge bundle is another potentially important approach that can be considered to improve the management of COPD e...
Source: Chronic Respiratory Disease - Category: Respiratory Medicine Authors: Tags: Chron Respir Dis Source Type: research