ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2015
Retrospective Assessment of Home Ventilation to Reduce Rehospitalization in Chronic Obstructive Pulmonary Disease.
Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 66 citations in OpenAlex.
- Why Home Noninvasive Ventilation Should Begin in the Hospital, Not at Home.American journal of respiratory and critical care medicine · 2024Article
- Home Noninvasive Ventilation in COPD.Chest · 2024Review
- Domiciliary noninvasive ventilation for chronic respiratory diseases.Medical journal, Armed Forces India · 2022Review
- Does testing for sleep-disordered breathing predischarge vs postdischarge result in different treatment outcomes?Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021Article
- Comprehensive and Collaborative Pharmacist Transitions of Care Service for Underserved Patients with Chronic Obstructive Pulmonary Disease.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2021Article
- Sleep in hospitalized patients with chronic obstructive pulmonary disease: an observational study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020Observational
- Article
- Is positive airway pressure therapy underutilized in chronic obstructive pulmonary disease patients?Expert review of respiratory medicine · 2019Review
- Noninvasive auto-titrating ventilation (AVAPS-AE) versus average volume-assured pressure support (AVAPS) ventilation in hypercapnic respiratory failure patients: comment.Internal and emergency medicine · 2018Article
- Noninvasive auto-titrating ventilation (AVAPS-AE) versus average volume-assured pressure support (AVAPS) ventilation in hypercapnic respiratory failure patients.Internal and emergency medicine · 2018Article
- CPAP Adherence and Readmission: Marker of Health or Cost-Effective Tool?Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2018Article
- Update: non-invasive ventilation in chronic obstructive pulmonary disease.Journal of thoracic disease · 2018Review
- Positive Airway Pressure Therapies and Hospitalization in Chronic Obstructive Pulmonary Disease.The American journal of medicine · 2017Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundHealthcare systems are attempting to reduce hospital readmissions due to chronic obstructive pulmonary disease (COPD).
methodsA retrospective study of a quality improvement (QI) program performed at a single center whose multifaceted intervention included nocturnal administration of advanced positive airway pressure (PAP) modality (or noninvasive positive pressure ventilation [NIPPV]) called averaged volume assured pressure support (AVAPS-AE) initiation by a respiratory therapist (RT), medication reconciliation by a pharmacist, adequate provision of oxygen, and ongoing RT-led care. In this QI program, consecutive patients who had been hospitalized twice in a single year with an acute COPD exacerbation underwent such interventions after they met specific selection criteria.
resultsThree-hundred ninety-seven consecutive patients were eligible for the program because they had two or more hospitalizations in the previous year. The proportion of patients who were readmitted on two or more occasions decreased from 100% (397 of 397) in the year prior to initiation of intervention to 2.2% (9 of 397) in the following year (χ(2) = 758, p < 0.0001). Seventy patients died over the one year following initiation of the multifaceted intervention. A composite outcome of rehospitalization and death was associated with inhaled steroids (adjusted odds ratio [adjOR] of 2.13; 95% confidence interval [CI] 1.09, 4.17; p = 0.02), whereas inhaled antimuscarinics tended to be associated with less risk for rehospitalization or death (adjOR 0.56; 95% CI 0.34, 1.03; p = 0.06).
conclusionIn a retrospective cohort study of a QI initiative undertaken at a single center, we have observed that a multifaceted intervention that involved initiation of nocturnal advanced PAP (NIPPV) modality, RT-led respiratory care, medication reconciliation, appropriate oxygen therapy initiation, and patient education led to significant reduction in rehospitalization.
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