Impact of clinical pathway on clinical outcomes in the management of COPD exacerbation

Rea Ban Yu-Lin, Aniza Ismail, Roslan Harun, Azahirafairud Abdul Rahman, Saperi Sulong, Syed Mohamed Al-Junid Syed Junid

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Exacerbations, a leading cause of hospitalization in patients with chronic obstructive pulmonary disease (COPD), affect the quality of life and prognosis. Treatment recommendations as provided in the evidence-based guidelines are not consistently followed, partly due to absence of simplified task-oriented approach to care. In this study, we describe the development and implementation of a clinical pathway (CP) and evaluate its effectiveness in the management of COPD exacerbation.Methods: We developed a CP and evaluated its effectiveness in a non-randomized prospective study with historical controls on patients admitted for exacerbation of COPD to Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Consecutive patients who were admitted between June 2009 and December 2010 were prospectively recruited into the CP group. Non-CP historical controls were obtained from case records of patients admitted between January 2008 and January 2009. Clinical outcomes were evaluated by comparing the length of stay (LOS), complication rates, readmissions, and mortality rates.Results: Ninety-five patients were recruited in the CP group and 98 patients were included in the non-CP historical group. Both groups were comparable with no significant differences in age, sex and severity of COPD (p = 0.641). For clinical outcome measures, patients in the CP group had shorter length of stay than the non-CP group (median (IQR): 5 (4-7) days versus 7 (7-9) days, p < 0.001) and 24.1% less complications (14.7% versus 38.8%, p < 0.001). We did not find any significant differences in readmission and mortality rates.Conclusion: The implementation of CP -reduced the length of stay and complication rates of patients hospitalized for acute exacerbation of COPD.

Original languageEnglish
Article number27
JournalBMC Pulmonary Medicine
Volume12
DOIs
Publication statusPublished - 22 Jun 2012

Fingerprint

Critical Pathways
Chronic Obstructive Pulmonary Disease
Disease Progression
Length of Stay
Mortality
Malaysia
Hospitalization
Quality of Life
Outcome Assessment (Health Care)
Prospective Studies
Guidelines

Keywords

  • Chronic obstructive pulmonary disease
  • Clinical outcomes
  • Clinical pathway
  • Length of stay

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Impact of clinical pathway on clinical outcomes in the management of COPD exacerbation. / Ban Yu-Lin, Rea; Ismail, Aniza; Harun, Roslan; Abdul Rahman, Azahirafairud; Sulong, Saperi; Syed Junid, Syed Mohamed Al-Junid.

In: BMC Pulmonary Medicine, Vol. 12, 27, 22.06.2012.

Research output: Contribution to journalArticle

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N2 - Background: Exacerbations, a leading cause of hospitalization in patients with chronic obstructive pulmonary disease (COPD), affect the quality of life and prognosis. Treatment recommendations as provided in the evidence-based guidelines are not consistently followed, partly due to absence of simplified task-oriented approach to care. In this study, we describe the development and implementation of a clinical pathway (CP) and evaluate its effectiveness in the management of COPD exacerbation.Methods: We developed a CP and evaluated its effectiveness in a non-randomized prospective study with historical controls on patients admitted for exacerbation of COPD to Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Consecutive patients who were admitted between June 2009 and December 2010 were prospectively recruited into the CP group. Non-CP historical controls were obtained from case records of patients admitted between January 2008 and January 2009. Clinical outcomes were evaluated by comparing the length of stay (LOS), complication rates, readmissions, and mortality rates.Results: Ninety-five patients were recruited in the CP group and 98 patients were included in the non-CP historical group. Both groups were comparable with no significant differences in age, sex and severity of COPD (p = 0.641). For clinical outcome measures, patients in the CP group had shorter length of stay than the non-CP group (median (IQR): 5 (4-7) days versus 7 (7-9) days, p < 0.001) and 24.1% less complications (14.7% versus 38.8%, p < 0.001). We did not find any significant differences in readmission and mortality rates.Conclusion: The implementation of CP -reduced the length of stay and complication rates of patients hospitalized for acute exacerbation of COPD.

AB - Background: Exacerbations, a leading cause of hospitalization in patients with chronic obstructive pulmonary disease (COPD), affect the quality of life and prognosis. Treatment recommendations as provided in the evidence-based guidelines are not consistently followed, partly due to absence of simplified task-oriented approach to care. In this study, we describe the development and implementation of a clinical pathway (CP) and evaluate its effectiveness in the management of COPD exacerbation.Methods: We developed a CP and evaluated its effectiveness in a non-randomized prospective study with historical controls on patients admitted for exacerbation of COPD to Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Consecutive patients who were admitted between June 2009 and December 2010 were prospectively recruited into the CP group. Non-CP historical controls were obtained from case records of patients admitted between January 2008 and January 2009. Clinical outcomes were evaluated by comparing the length of stay (LOS), complication rates, readmissions, and mortality rates.Results: Ninety-five patients were recruited in the CP group and 98 patients were included in the non-CP historical group. Both groups were comparable with no significant differences in age, sex and severity of COPD (p = 0.641). For clinical outcome measures, patients in the CP group had shorter length of stay than the non-CP group (median (IQR): 5 (4-7) days versus 7 (7-9) days, p < 0.001) and 24.1% less complications (14.7% versus 38.8%, p < 0.001). We did not find any significant differences in readmission and mortality rates.Conclusion: The implementation of CP -reduced the length of stay and complication rates of patients hospitalized for acute exacerbation of COPD.

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