Pre-Discharge Bundle for Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease to Reduce Readmissions

Study Overview
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Brief Summary
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Hospital readmissions for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) pose burdens to the healthcare system and patients. The aim of this study was to determine whether a screening and educational tool, administered prior to discharge, would result in a decrease in the rate of hospital readmissions.

Detailed Description
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Hospital readmissions for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) pose burdens to the healthcare system and patients. A current gap in knowledge is whether a pre-discharge screening and educational tool, administered to patients with COPD, reduces readmissions and emergency department (ED) visits. A single center, randomized trial of patients admitted with AECOPD. Patients will be randomized to control (standard care) or bundle group in which patients receive smoking cessation counseling, screening for gastroesophageal reflux disease and depression or anxiety, standardized inhaler teaching, and a 48-hour post-discharge phone call.

Official Title
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Pre-Discharge Bundle for Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease to Reduce Readmissions and Emergency Department Visits: a Randomized, Controlled Trial.

Conditions
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Chronic Obstructive Pulmonary Disease, Exacerbation of Chronic Obstructive Pulmonary Disease

Intervention / Treatment
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* Behavioral: Bundle tool


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosis of COPD with the presence of an AECOPD Age > 40 Current or ex-smoker with history of at least 20 pack-years Exclusion Criteria: Past history of asthma, interstitial lung disease, bronchiectasis, presence of airway hardware (e.g. tracheal stents or tracheotomy), lung cancer, any other cancer with a life expectancy of less than 1 year Presence of a language barrier Residence in a nursing home Intensive care unit stay during the current admission Delirium or dementia.

Ages Eligible for Study
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Minimum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control<br>Group of patients undergo standard care as determined by the primary inpatient team | |
| Experimental: Bundle<br>Group of patients that receive the screening and educational tool | Behavioral: Bundle tool<br>* Tool consists of 1. screening measures to identify the presence of various risk factors for COPD exacerbations and 2. Educational components for the disease of COPD.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 30 day readmission rate | Time until readmission or ER visit, 30 days | 30 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Chronic Obstructive Pulmonary Disease, COPD, Readmissions