An Evaluation of Post Discharge Utilization Among Patients With an Acute Exacerbation of COPD

Wake Forest University (WFU)

Status: Completed

Conditions: Chronic Obstructive Pulmonary Disease

Treatments: Other: Usual Care; Other: COPD Clinical Pathway

Study type: Interventional

Funder types: Other

Identifiers

NCT03207776

00021790

Details and patient eligibility

About

Patients who are hospitalized at select Carolinas Healthcare System (CHS) sites with Chronic Obstructive Pulmonary Disorder (COPD) acute exacerbation symptoms will be treated per the CHS COPD Clinical Pathway. Patient outcomes will be followed, including but not limited to readmission. Patients on the pathway will also have access to navigator services.

Full description

Patients hospitalized at participating CHS sites with COPD acute exacerbation symptoms, will be treated per the CHS COPD clinical pathway. The COPD clinical pathway will include four components: (i) discrete, evidence-based care steps (ii) patient navigation, (iii) daily data driven care gap identification, (iv) monthly leadership huddles. These components are all part of usual care for patients in this population, but each component is not applied to patients consistently across the System. For this reason, the pathway will be applied consistently and completely in patients meeting COPD acute exacerbation criteria at participating sites. Patients will be followed for 60 days in total after discharge from their COPD acute exacerbation symptoms to determine the potential effectiveness of complete implementation of all 4 components in the care of COPD patients. Patients on the pathway will also have access to navigator services.

Enrollment: 4,832 patients

Sex: All

Ages: 40+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Identified as having an acute exacerbation of COPD within 24 hours of admission

Exclusion criteria

• Death during the index encounter
• No initial discharge as of the end of the study period

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

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4,832 participants in 2 patient groups

Control

Other group

Description:

Treatment of patients in the usual manner based on their diagnosis and resources available at that site (Usual Care).

Treatment:

Other: Usual Care

Intervention

Other group

Description:

A group of 4 Usual Care components that are applied consistently and completely amongst all patients who present with COPD acute exacerbation symptoms, plus access to navigator services (COPD Clinical Pathway).

Treatment:

Other: COPD Clinical Pathway