Full Citation
Title: An Evaluation of Respiratory Therapist-Delivered COPD Self-Management Education and Hospital Readmissions
Citation Type: Dissertation/Thesis
Publication Year: 2015
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Abstract: BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death in USA, known to annually cause 134,676 American deaths. In 2011, it was estimated that 12.7 million adults were living with COPD and there are over 800,000 COPD-related hospital admissions in the USA annually. The increase in prevalence of COPD, and the severity of the disease, highlights the need for intervention in COPD treatment with a focus on prevention of exacerbations and self-management. Current research illustrates a number of ways to effectively manage COPD disease progression including: use of the GOLD guidelines to classify and treat COPD, medication, smoking cessation, and proper self-management of disease. However, there is very little research exploring the impact of healthcare provider-delivered, comprehensive patient education and smoking cessation counseling to improve self-management of COPD and contribute to the prevention of hospital readmissions. PURPOSE: The purpose of this study was to determine the perceived benefits and potential reduction of hospital readmission following COPD disease self-management education and smoking cessation counselling facilitated by trained Respiratory Therapists (RT). METHODS: A retrospective chart review of the first 10 months of an RT-delivered COPD education service with COPD patients on a specific service at The Wexner Medical Center was conducted. RTs administered patient education and recorded an assessment and evaluation in the electronic health record regarding the education session. A COPD assessment test (CAT) was also administered together with initial assessment of the patient by respiratory therapist. After collection of initial assessment data and delivery of the CAT instrument, patients were seen for follow-up by an RT and received tailored COPD education. Following the education session, patients were seen again once or twice more before they were discharged. The group of COPD patients who were not seen by the RT for patient education was also examined Results: Eighty three out of 204 (40.7%) patients with primary or secondary diagnosis of COPD received COPD education by Respiratory Therapists. These patients also had an average of over 2 hospitalizations in the past year, average smoking history of 39.3 pack years and over 3 additional comorbidities at the time of hospitalization. Greater than 85% of admitted patients with COPD diagnosis, who self-identified as current smokers, did not receive NRT. The percentage of respiratory related readmissions for patients seen by respiratory therapists and not seen by respiratory therapists was 10.8% and 11.6% respectively. The number of patients who received pulmonary rehabilitation prior to admission was 10 (12%). Conclusion: COPD education provided by an RT is a valuable intervention to managing COPD patients disease progression. RTs can play a larger role by contributing more to the COPD management program including smoking cessation programs and pulmonary rehabilitation information/counseling as part of the COPD education. RTs can also be placed at transitional care to provide more long term management of patients with COPD. Medication management should include tailored medication based on individual patients GOLD classification and should be a critical part of the COPD education provided by RTs.
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Authors: Sim, Riana
Institution: Respiratory Therapy Division, School of Health and Rehabilitation Sciences
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Publisher Location: PA
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Data Collections: IPUMS Health Surveys - NHIS
Topics: Health, Methodology and Data Collection
Countries: United States