Readmission to hospital is one of the most important problems in chronic obstructive pulmonary disease (COPD) patients who developed chronic respiratory failure. Patients receiving long-term oxygen therapy (LTOT) and noninvasive ventilation (NIV) constitute the most vulnerable group because of the need for comprehensive care. However, because of lack of health care support systems in Turkey, many advanced COPD patients are hospitalized due to preventable problems such as insufficient knowledge about the therapies, nonadherence to therapy and technical issues related to LTOT/NIV equipment. The aim of this multicenter randomized trial is to find out whether a structured discharge and follow-up protocol reduce the rate of unplanned, COPD-related hospital readmissions over 90 days in patients receiving LTOT or NIV.
The study is planned with Turkish Thoracic Society and Global Alliance Against Respiratory Disease-Turkey partnership and being carried out 10 centers throughout Turkey. COPD patients who are prescribed long-term oxygen therapy for hypoxemic respiratory failure and/or noninvasive ventilation for hypercapnic respiratory failure will be included in the study and will be randomized to either intervention or control arm. The intervention mainly consists of not only education about the disease and medications but also the education of the equipment and how to use it to have the best benefit. Control arm patients will receive usual care, which consists of basic education of the patient about the therapies. The primary outcome of the study is readmission in 90 days.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
160
Dokuz Eylul University
Izmir, Narlıdere, Turkey (Türkiye)
Cukurova University
Adana, Turkey (Türkiye)
Gazi University
Ankara, Turkey (Türkiye)
Health Sciences University Ataturk Chest Diseases and Chest Surgery Hospital
Ankara, Turkey (Türkiye)
Uludag University
Bursa, Turkey (Türkiye)
Duzce University
Düzce, Turkey (Türkiye)
Ataturk University
Erzurum, Turkey (Türkiye)
Health Sciences University Sureyyapasa Chest Diseases and Chest Surgery Hospital
Istanbul, Turkey (Türkiye)
Ege University
Izmir, Turkey (Türkiye)
Celal Bayar University
Manisa, Turkey (Türkiye)
Readmission rate
The rate of unplanned, COPD-related hospital readmissions over 90 days after discharge
Time frame: 90days
Time to first exacerbation
Time to first exacerbation after discharge
Time frame: 90 days
Rate of exacerbation
Total COPD exacerbation rate within 90 days after discharge
Time frame: 90 days
Rate of hospitalization
Total hospitalization number due to COPD within 90 days after discharge
Time frame: 90 days
Compliance to treatment
Compliance to LTOT and NIV therapies will be assessed by duration of use (number of hours per day and number of nights per week) within 90 days after discharge.
Time frame: 90 days
Long term survival
One year survival after discharge
Time frame: One year
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