Evidence map›Paper›PMID 25679218›Full record

ArticlePloS one2015

Impact of a COPD discharge care bundle on readmissions following admission with acute exacerbation: interrupted time series analysis.

Anthony A Laverty, Sarah L Elkin, Hilary C Watt, Christopher Millett, Louise J Restrick, Sian Williams, Derek Bell, Nicholas S Hopkinson

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PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  4. A Proposed Checklist for Optimizing COPD Patient Discharge Processes in Italian Internal Medicine Wards.International journal of chronic obstructive pulmonary disease · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Anthony A LavertyDepartment of Primary Care and Public Health, Imperial College London, London, England.
Sarah L ElkinImperial College London NHS Trust, London, England.
Hilary C WattDepartment of Primary Care and Public Health, Imperial College London, London, England.
Christopher MillettDepartment of Primary Care and Public Health, Imperial College London, London, England.
Louise J RestrickLondon Respiratory Team NHS London, London, England.
Sian WilliamsLondon Respiratory Team NHS London, London, England.
Derek BellNIHR CLAHRC for Northwest London, London, England.
Nicholas S HopkinsonNIHR Respiratory Biomedical Research Unit at Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, England.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesWe evaluated the impact of a COPD discharge care bundle on readmission rates following hospitalisation with an acute exacerbation.

designInterrupted time series analysis, comparing readmission rates for COPD exacerbations at nine trusts that introduced the bundle, to two comparison groups; (1) other NHS trusts in London and (2) all other NHS trusts in England. Care bundles were implemented at different times for different NHS trusts, ranging from October 2009 to April 2011.

settingNine NHS acute trusts in the London, England.

participantsPatients aged 45 years and older admitted to an NHS acute hospital in England for acute exacerbation of COPD. Data come from Hospital Episode Statistics, April 2002 to March 2012.

main outcome measuresAnnual trend readmission rates (and in total bed days) within 7, 28 and 90 days, before and after implementation.

resultsIn hospitals introducing the bundle readmission rates were rising before implementation and falling afterwards (e.g. readmissions within 28 days +2.13% per annum (pa) pre and -5.32% pa post (p for difference in trends = 0.012)). Following implementation, readmission rates within 7 and 28 day were falling faster than among other trusts in London, although this was not statistically significant (e.g. readmissions within 28 days -4.6% pa vs. -3.2% pa, p = 0.44). Comparisons with a national control group were similar.

conclusionsThe COPD discharge care bundle appeared to be associated with a reduction in readmission rate among hospitals using it. The significance of this is unclear because of changes to background trends in London and nationally.

Indexed as

Disease ProgressionInterrupted Time Series AnalysisPatient AdmissionPatient Care BundlesHospitalsHumansLength of StayLondonMiddle AgedNational Health ProgramsPatient DischargePatient ReadmissionPulmonary Disease, Chronic ObstructiveRetrospective Studies

Identifiers

PMID25679218
PMCPMC4332682

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.