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

Overview

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.

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

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Double (Care Provider, Investigator)
  • Study Primary Completion Date: April 2013

Detailed Description

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.

Interventions

  • Behavioral: Bundle tool
    • 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.

Arms, Groups and Cohorts

  • No Intervention: Control
    • Group of patients undergo standard care as determined by the primary inpatient team
  • Experimental: Bundle
    • Group of patients that receive the screening and educational tool

Clinical Trial Outcome Measures

Primary Measures

  • 30 day readmission rate
    • Time Frame: 30 days
    • Time until readmission or ER visit, 30 days

Participating in This Clinical Trial

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.

Gender Eligibility: All

Minimum Age: 40 Years

Maximum Age: 99 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Henry Ford Health System
  • Provider of Information About this Clinical Study
    • Principal Investigator: Jeffrey Jennings, Staff Physician – Henry Ford Health System

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