Association of a Respiratory Therapist-Led COPD Hospital Education Program and 30-day Hospital Readmissions

Abstract

Background:

COPD is a prevalent disease that is of monumental concern to patients, pulmonary providers, healthcare systems, and the Centers for Medicaid and Medicare Service. This study aims to evaluate hospital readmissions for subjects admitted for exacerbation of COPD who are given standard of care for COPD vs a respiratory therapist (RT)-led COPD hospital education program.

Methods:

An institutional review board exempt retrospective chart review was completed with a pre/post-intervention study. This study compared readmissions for subjects with COPD exacerbation who received standard of care vs RT-led COPD hospital education program. Subjects ≥18 years old were included in the pre-intervention cohort if they had a diagnosis of exacerbation of COPD and were admitted to a medical center in Northeast New Jersey from February 2020 to January 2021. The RT-led hospital education program is a 1-hour education session, which included disease management, review of the COPD Action Plan, proper inhaler technique, completion of the COPD Assessment Test (CAT), sleep apnea screening, self-management aimed at early mobility, and coping with anxiety and depression. When required, subjects received education on home oxygen safety and smoking cessation counseling. Discharge strategies include talks on the Better Breathers Support Group and confirmation of outpatient pulmonologist follow-up within 7 days of discharge. All subjects received post hospital phone calls on days 1-3 and 7-9. Minitab statistical software was used to calculate the 30-day readmission rates for both cohorts. Categorical and continuous baseline data were analyzed using chi square tests and two sample t-tests or Mann-Whitney U tests, respectively.

Results:

A total of 235 subjects were included in the study, 112 in the pre-intervention cohort and 123 in the post-intervention cohort. Patient demographics between the two cohorts were similar, with subjects with mean age around 70 years old and majority of subjects were current or former smokers. Comorbidities were similar between the two cohorts. In the pre-intervention cohort, 15.18% (17) of subjects were readmitted within 30 days of discharge compared to 9.76% (12) in the post-intervention cohort (P = 0.209).

Conclusions:

Although not statistically significant, there was a numerical decrease in readmission rates in the RT-led group compared to standard of care. Future research recommendations include enrolling more subjects into the study to meet power.