Breaking News
May 3, 2019 - Vaping and Smoking May Signal Greater Motivation to Quit
May 3, 2019 - Dementia looks different in brains of Hispanics
May 3, 2019 - Short-Staffed Nursing Homes See Drop In Medicare Ratings
May 3, 2019 - Study of teens with eating disorders explores how substance users differ from non-substance users
May 3, 2019 - Scientists develop new video game that may help in the study of Alzheimer’s
May 3, 2019 - Arc Bio introduces Galileo Pathogen Solution product line at ASM Clinical Virology Symposium
May 3, 2019 - Cornell University study uncovers relationship between starch digestion gene and gut bacteria
May 3, 2019 - How to Safely Use Glucose Meters and Test Strips for Diabetes
May 3, 2019 - Anti-inflammatory drugs ineffective for prevention of Alzheimer’s disease
May 3, 2019 - Study tracks Pennsylvania’s oil and gas waste-disposal practices
May 3, 2019 - Creating a better radiation diagnostic test for astronauts
May 3, 2019 - Vegans are often deficient in these four nutrients
May 3, 2019 - PPDC announces seed grants to develop medical devices for children
May 3, 2019 - Study maps out the frequency and impact of water polo head injuries
May 3, 2019 - Research on Reddit identifies risks associated with unproven treatments for opioid addiction
May 3, 2019 - Good smells may help ease tobacco cravings
May 3, 2019 - Medical financial hardship found to be very common among people in the United States
May 3, 2019 - Researchers develop multimodal system for personalized post-stroke rehabilitation
May 3, 2019 - Study shows significant mortality benefit with CABG over percutaneous coronary intervention
May 3, 2019 - Will gene-editing of human embryos ever be justifiable?
May 3, 2019 - FDA Approves Dengvaxia (dengue vaccine) for the Prevention of Dengue Disease in Endemic Regions
May 3, 2019 - Why Tonsillitis Keeps Coming Back
May 3, 2019 - Fighting the opioid epidemic with data
May 3, 2019 - Maggot sausages may soon be a reality
May 3, 2019 - Deletion of ATDC gene prevents development of pancreatic cancer in mice
May 2, 2019 - Targeted Therapy Promising for Rare Hematologic Cancer
May 2, 2019 - Alzheimer’s disease is a ‘double-prion disorder,’ study shows
May 2, 2019 - Reservoir bugs: How one bacterial menace makes its home in the human stomach
May 2, 2019 - Clinical, Admin Staff From Cardiology Get Sneak Peek at Epic
May 2, 2019 - Depression increases hospital use and mortality in children
May 2, 2019 - Vicon and NOC support CURE International to create first gait lab in Ethiopia
May 2, 2019 - Researchers use 3D printer to make paper organs
May 2, 2019 - Viral infection in utero associated with behavioral abnormalities in offspring
May 2, 2019 - U.S. Teen Opioid Deaths Soaring
May 2, 2019 - Opioid distribution data should be public
May 2, 2019 - In the Spotlight: “I’m learning every single day”
May 2, 2019 - 2019 Schaefer Scholars Announced
May 2, 2019 - Podcast: KHN’s ‘What The Health?’ Bye-Bye, ACA, And Hello ‘Medicare-For-All’?
May 2, 2019 - Study describes new viral molecular evasion mechanism used by cytomegalovirus
May 2, 2019 - SLU study suggests a more equitable way for Medicare reimbursement
May 2, 2019 - Scientists discover first gene involved in lower urinary tract obstruction
May 2, 2019 - Researchers identify 34 genes associated with increased risk of ovarian cancer
May 2, 2019 - Many low-income infants receive formula in the first few days of life, finds study
May 2, 2019 - Global study finds high success rate for hip and knee replacements
May 2, 2019 - Taking depression seriously: What is it?
May 2, 2019 - With Head Injuries Mounting, Will Cities Put Their Feet Down On E-Scooters?
May 2, 2019 - Scientists develop small fluorophores for tracking metabolites in living cells
May 2, 2019 - Study casts new light into how mothers’ and babies’ genes influence birth weight
May 2, 2019 - Researchers uncover new brain mechanisms regulating body weight
May 2, 2019 - Organ-on-chip systems offered to Asia-Pacific regions by Sydney’s AXT
May 2, 2019 - Adoption of new rules drops readmission penalties against safety net hospitals
May 2, 2019 - Kids and teens who consume zero-calorie sweetened beverages do not save calories
May 2, 2019 - Improved procedure for cancer-related erectile dysfunction
May 2, 2019 - Hormone may improve social behavior in autism
May 2, 2019 - Alzheimer’s disease may be caused by infectious proteins called prions
May 2, 2019 - Even Doctors Can’t Navigate Our ‘Broken Health Care System’
May 2, 2019 - Study looks at the impact on criminal persistence of head injuries
May 2, 2019 - Honey ‘as high in sugars as table sugar’
May 2, 2019 - Innovations to U.S. food system could help consumers in choosing healthy foods
May 2, 2019 - FDA Approves Mavyret (glecaprevir and pibrentasvir) as First Treatment for All Genotypes of Hepatitis C in Pediatric Patients
May 2, 2019 - Women underreport prevalence and intensity of their own snoring
May 2, 2019 - Concussion summit focuses on science behind brain injury
May 2, 2019 - Booker’s Argument For Environmental Justice Stays Within The Lines
May 2, 2019 - Cornell research explains increased metastatic cancer risk in diabetics
May 2, 2019 - Mount Sinai study provides fresh insights into cellular pathways that cause cancer
May 2, 2019 - Researchers to study link between prenatal pesticide exposures and childhood ADHD
May 2, 2019 - CoGEN Congress 2019: Speakers’ overviews
May 2, 2019 - A new strategy for managing diabetic macular edema in people with good vision
May 2, 2019 - Sagent Pharmaceuticals Issues Voluntary Nationwide Recall of Ketorolac Tromethamine Injection, USP, 60mg/2mL (30mg per mL) Due to Lack of Sterility Assurance
May 2, 2019 - Screen time associated with behavioral problems in preschoolers
May 2, 2019 - Hormone reduces social impairment in kids with autism | News Center
May 2, 2019 - Researchers synthesize peroxidase-mimicking nanozyme with low cost and superior catalytic activity
May 2, 2019 - Study results of a potential drug to treat Type 2 diabetes in children announced
May 2, 2019 - Multigene test helps doctors to make effective treatment decisions for breast cancer patients
May 2, 2019 - UNC School of Medicine initiative providing unique care to dementia patients
May 2, 2019 - Nestlé Health Science and VHP join forces to launch innovative COPES program for cancer patients
May 2, 2019 - Study examines how our brain generates consciousness and loses it during anesthesia
May 2, 2019 - Transition Support Program May Aid Young Adults With Type 1 Diabetes
May 2, 2019 - Study shows how neutrophils exacerbate atherosclerosis by inducing smooth muscle-cell death
May 2, 2019 - Research reveals complexity of how we make decisions
Self-care program for COPD patients reduces emergency room visits and burdensome symptoms

Self-care program for COPD patients reduces emergency room visits and burdensome symptoms

Johns Hopkins Medicine researchers report that a program designed to enhance self-care and lead to more seamless management of chronic obstructive pulmonary disease (COPD) in adults successfully reduced rates of emergency room visits and hospitalization, and the burdensome symptoms and limitations caused by the condition.

Describing results of the six-month trial of the program in the Nov. 12 issue of The Journal of the American Medical Association, the investigators said patients in the new program (called BREATHE) were re-hospitalized at half the rate of a similar group of patients who received standard care without the program. BREATHE patients also reported improved quality of life, the research team said–a boon to high value health care efforts being made in the field of medicine.

“When a person with COPD gets admitted to the hospital with difficulty breathing, the doctors and nurses focus on their immediate problem and not their chronic disease and overall health, and so the chance that the person will have another flare-up and end up in the hospital again remains high,” says lead author Hanan Aboumatar, M.D., M.P.H., associate professor of medicine at the Johns Hopkins University School of Medicine. “About half of patients will end up back in the hospital within six months.”

“COPD is incurable and chronic, and our new program–which combines hospital to home transition support with chronic disease management support–is one way of reorganizing care in a way that reduces future hospitalization risk and expenses, while preserving patients’ quality of life,” she adds.

COPD is a label applied to a group of chronic conditions –including emphysema and chronic bronchitis– that damage the lungs and cause breathing problems. An estimated 16 million Americans are living with COPD, generating costs to the health care system of more than $30 billion annually, according to the Centers for Disease Control and Prevention.

Smoking, air pollution, lung injury and genetics can all play a role in the development of COPD. Coughing, shortness of breath and wheezing symptoms range in severity, and people with COPD often experience worsening flare-ups over time.

Because the damage is irreversible and progressive, treatment focus is on symptom management with drugs, oxygen, and lifestyle changes. Previous studies have shown that patients who follow a set of strategies to manage their COPD do much better and have a greater quality of life, says Aboumatar, but “getting these strategies to patients and ensuring their successful use has been a challenge.”

To address that challenge, Aboumatar and her colleagues teamed up with COPD patients and caregivers to design a program that would give patients better support immediately after being hospitalized with a COPD flare-up.

Specifically, the program–delivered to COPD patients admitted to medical units at the Johns Hopkins Bayview Medical Center between March 2015 and May 2016–paired patients and their family caregivers with a COPD nurse who met with them during hospitalization. The nurse continued consultation with the patient and caregiver, on average, 6.1 times over the three months after hospitalization through phone calls and/or home visits depending on patients’ preference.

The nurse offered tailored support on how to take medications, use inhalers and breathing techniques, and manage COPD symptoms. In addition, the nurse worked through issues patients may face when living with COPD, including access to care, mobility services and other community resources.

Overall, 240 patients hospitalized for COPD were randomized to receive either the standard of care or the new three-month program. The control and intervention groups had average patient ages of 63.9 and 66, respectively, were 36.7 and 40 percent men, and 83.3 and 81.6 percent white. Participants in both groups had been diagnosed with COPD for an average of three years. The patients’ hospitalizations and emergency department visits, as well as quality of life scores, were tracked for six months from the time of initial hospitalization.

Some 203 patients completed the six months of follow-up. During that time, there were 15 deaths and 337 subsequent hospitalizations. The number of COPD-related acute care events–either hospitalization or emergency department visits–per participant was 1.4 in the control group and 0.72 among those enrolled in the new program.

In addition, the quality of life– as measured by a standard questionnaire known as the St. George’s Respiratory Questionnaire–showed better scores in the intervention compared to the control group. While the score declined by 1.53 points on average over the six months of study for those in the intervention group, it increased by 5.44 points for those in the control group. The St. George’s Respiratory Questionnaire scores range from 0-100 (lower scores indicate better quality of life), and a four-point difference on the 100 point scale is considered clinically meaningful.

“Our findings support the idea that a comprehensive program that reorganizes care for patients to help address long-term COPD self-management at a time when they’re already struggling with a hospitalization due to a COPD flare-up is more effective than limited support that is focused on recovery from the current hospitalization,” says Aboumatar. “When hospitalized due to a COPD flare-up, this condition becomes more of a priority, so it’s a good moment to start a conversation with a patient about what they can do to successfully manage it.” Aboumatar adds that having the same nurse interact with patients both in the hospital setting and after discharge helped build a relationship that allowed the patients to communicate effectively with and trust their nurse.

Aboumatar and her colleagues plan to test the program in other settings. She acknowledges that the program may be less feasible in rural areas, where patients and resources are more geographically spread out. The program is also being adapted for potential use with other chronic diseases marked by acute flare-ups, such as congestive heart failure.

The BREATHE program was developed in partnership with COPD patients, their family caregivers and clinicians of various disciplines.

Source:

https://www.hopkinsmedicine.org/news/newsroom/news-releases/study-self-management-program-for-patients-with-copd-boosts-quality-of-life-cuts-rehospitalization-risk

Tagged with:

About author

Related Articles