Retrospective Assessment of Home Ventilation to Reduce Rehospitalization in Chronic Obstructive Pulmonary Disease

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
Steven CoughlinSairam Parthasarathy

Abstract

Healthcare systems are attempting to reduce hospital readmissions due to chronic obstructive pulmonary disease (COPD). A retrospective study of a quality improvement (QI) program performed at a single center whose multifaceted intervention included nocturnal administration of advanced positive airway pressure (PAP) modality (or noninvasive positive pressure ventilation [NIPPV]) called averaged volume assured pressure support (AVAPS-AE) initiation by a respiratory therapist (RT), medication reconciliation by a pharmacist, adequate provision of oxygen, and ongoing RT-led care. In this QI program, consecutive patients who had been hospitalized twice in a single year with an acute COPD exacerbation underwent such interventions after they met specific selection criteria. Three-hundred ninety-seven consecutive patients were eligible for the program because they had two or more hospitalizations in the previous year. The proportion of patients who were readmitted on two or more occasions decreased from 100% (397 of 397) in the year prior to initiation of intervention to 2.2% (9 of 397) in the following year (χ(2) = 758, p < 0.0001). Seventy patients died over the one year following initiation of the multifaceted intervention. A composi...Continue Reading

Citations

May 18, 2016·The Lancet. Respiratory Medicine·MeiLan K HanMark T Dransfield
Feb 6, 2017·Respirology : Official Journal of the Asian Pacific Society of Respirology·Claus F VogelmeierAlvar Agusti
Oct 3, 2018·Current Opinion in Pulmonary Medicine·Neeraj M Shah, Patrick B Murphy
Jul 6, 2020·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Nancy H StewartVineet M Arora
Jul 7, 2020·PloS One·David TroutTeofilo L Lee-Chiong
Mar 25, 2017·COPD·Jean-Michel ArnalAude Garnero
Aug 2, 2016·Expert Review of Medical Devices·Bernardo Selim, Kannan Ramar
Mar 17, 2017·The European Respiratory Journal·Jadwiga A WedzichaJerry A Krishnan
Feb 2, 2019·Expert Review of Respiratory Medicine·Hrishikesh Kulkarni, Sairam Parthasarathy
Jun 12, 2019·Annals of the American Thoracic Society·John M ColemanRavi Kalhan
Jul 4, 2021·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Cinthya Pena OrbeaTimothy I Morgenthaler
Aug 12, 2021·COPD·Isobel SharpeDon Thiwanka Wijeratne

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