Background: Exacerbation of chronic obstructive pulmonary disease (COPD) is the second leading cause of emergency admission to medical departments. According to former studies, patients with COPD often awaits and do not react in time to signs of disease worsening, which may result in delay of treatment and inappropriate hospital admissions.
Aim/objectives: Contributes to increase patients' quality of life and prognosis through an intensified proactive effort and development of competence of patients with COPD, relatives and healthcare professionals involved across sector boundaries, focusing on earlier identification and better treatment of exacerbation of COPD.
Method: A development study. Through literature and medical journal audit, a tool was developed to identify patients with COPD at special risk for readmission to hospital. Through one year 98 patients were identified and offered two visits at home by a clinical pulmonary nurse specialist after admission, respectively, two weeks and four weeks after discharge. Focus was on earlier identification and better treatment of exacerbation of COPD. Also user perspectives were involved in the outcome through 11 semi-structured interviews of selected patients following complete study visits.
Results: There were no changes in amount of readmissions during the study. The study patients were experienced in managing COPD symptoms and medication, but expressed an unmet need for COPD qualified help from primary care.
Conclusion: This particular group of vulnerable patients with COPD had a heavy symptom burden in everyday life. They were experienced in their COPD disease management. The patients therefore had a need for special treatment and care during even a small exacerbation.