Clinical Outcome of a Cross-Sectorial Lung Team Treating Patients with COPD at High Risk of Exacerbation: A Randomized Controlled Trial

Iversen, Birgit Refsgaard; Rodkjær, Lotte Ørneborg; Bregnballe, Vibeke; Løkke, Anders

doi:10.1080/15412555.2021.1898577

Cited by 5 publications

(3 citation statements)

References 20 publications

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“…Although, in our study all items in the CAT score, except for ‘chest tightness’ and all items of EQ‐5D, except for ‘pain and discomfort’ showed a numerical improvement in the intervention group. Hence, affiliation to a CLT seems beneficial in terms of reduced COPD‐related hospitalisation and length of hospital stay [10], and safe with respect to HRQoL as no significant deteriorations was demonstrated.…”

Section: Discussionmentioning

confidence: 99%

“…As this study was a part of a larger project, the sample size calculation was based on data on length of hospital stay related to AECOPD which was a part of the project's primary outcomes [10]. The sample size calculation was measured based on data from the pilot study [28].…”

Section: Sample Size Calculationmentioning

confidence: 99%

“…A randomised controlled trial (RCT) performed between 2017 and 2020 investigated the effects on hospitalisation and length of hospital stay of affiliating patients with COPD to a cross‐sectorial lung team (CLT). The study showed statistically significant reduction in COPD‐related hospitalisations and length of hospital stay for patients affiliated to a CLT versus patients receiving usual care [10]. As an additional part of that study, we aimed to investigate whether affiliation to a CLT had impact on well‐being and daily life, HRQoL as well as symptoms of anxiety and depression versus patients receiving usual care.…”

Section: Introductionmentioning

confidence: 99%

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Does affiliation to a cross‐sectorial lung team impact well‐being, health‐related quality of life, symptoms of anxiety and depression and patient involvement in patients with COPD? A randomised controlled trial

Iversen

Løkke

Bregnballe

et al. 2021

Scandinavian Caring Sciences

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Background Chronic obstructive pulmonary disease (COPD) is a progressive lung disease causing limitations in daily life. A cross‐sectorial lung team was established for COPD patients at risk of hospitalisation due to exacerbation of COPD. Aims To investigate the impact of affiliation to a cross‐sectorial lung team on well‐being, health‐related quality of life, symptoms of anxiety and depression and patient involvement in patients with severe COPD. Methods A randomised controlled trial was conducted from September 2017 to March 2020. In total, 109 patients were included for analysis in the study: 53 patients were affiliated to a cross‐sectorial lung team and 56 patients received usual care. The patients were included for 1 year. Data were collected at baseline and at follow‐up after 1 year. Data were collected using COPD Assessment Test (CAT), Hospital Anxiety and Depression Scale (HADS), EuroQol 5‐Dimensions (EQ‐5D) and Patient Assessment of Chronic Illness Care (PACIC). Results The questionnaire response rate was between 84% and 96%. No statistically significant differences were detected between patients affiliated to the cross‐sectorial lung team and patients receiving usual care, in either patient's well‐being, health‐related quality of life, symptoms of anxiety and depression, or patient involvement. However, CAT‐total score decreased with −0.21(95%CI: −1.63; 1.20) for patients affiliated to the cross‐sectorial lung team and increased with 1.44(95%CI; −0.11; 3.00) for patients receiving usual care. Conclusion Affiliation to the cross‐sectorial lung team seems safe as it did not deteriorate the patients' well‐being, symptoms of anxiety and depression, health‐related quality of life or patient involvement. Further research is needed and interviewing patients to obtain more knowledge on their experiences might be preferable.

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Section: Discussionmentioning

confidence: 99%

Section: Sample Size Calculationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Does affiliation to a cross‐sectorial lung team impact well‐being, health‐related quality of life, symptoms of anxiety and depression and patient involvement in patients with COPD? A randomised controlled trial

Iversen

Løkke

Bregnballe

et al. 2021

Scandinavian Caring Sciences

Self Cite

View full text Add to dashboard Cite

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Experiences of patients with advanced COPD affiliated to a cross‐sectorial outgoing lung team: A qualitative study

Refsgaard,

Løkke,

Bregnballe

et al. 2024

Journal of Advanced Nursing

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AimTo explore experiences of patients affiliated to a cross‐sectorial outgoing lung team.BackgroundThe outgoing lung team consisted of respiratory nurses from the hospital and community nurses. The lung team offered 24/7 help to patients with advanced chronic obstructive pulmonary disease (COPD) through visits and/or treatment in the patients' home. Affiliation to the lung team reduced both hospitalizations and length of hospital stay due to acute exacerbation of COPD. However, based on questionnaires on health‐related quality of life, no significant differences were found between patients affiliated to the lung team and patients receiving usual care.DesignA qualitative interview study.MethodsIn total, 16 patients, aged 61–88 years were interviewed between February 2019 and July 2021. They had been affiliated to the outgoing lung team for 1–3 years. Semi‐structured interviews were conducted in the patients' home and audio‐recorded after informed consent was obtained. The interviews were transcribed verbatim and analysed, inspired by systematic text condensation by Malterud.FindingsFour themes emerged from the analysis: (1) feeling safe, (2) improvements in living with COPD, (3) avoiding hospitalization and (4) satisfied with staying at home.ConclusionAffiliation to the cross‐sectorial outgoing lung team gave the patients peace of mind and improved their ability to live with advanced COPD. The patients preferred contacting the lung team because they could stay at home and receive treatment, and thus avoid hospitalization.ImpactThe findings from this study support that municipalities should consider implementing an outgoing lung team, as it has the potential to bring several benefits, including improving patient self‐management.Reporting MethodThe manuscript adhered to Consolidated criteria for reporting qualitative research (COREQ) guideline.Patient or Public ContributionPatients were interviewed. Additionally, no patient or public contributed to the design or conduction of the study, analysis, or interpretation of the data.

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Preparing safe discharge in a complex practice: A qualitative study of nurses' approach to patients with COPD's hospital discharge from two pulmonary medicinal wards

Gregersen,

Refsgaard,

Sørensen

2024

Scandinavian Caring Sciences

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IntroductionIt remains unclear why 17% of patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) treated in Danish hospitals are readmitted within 30 days. Hospital discharge is multifaceted. However, the preparation process and nurses' efforts may be essential in ensuring a successful discharge.AimTo explore the process of preparing discharge for patients with COPD in a hospital setting.MethodUsing constructivist grounded theory, we observed 11 nurses' work at two pulmonary medical wards using participant observation. Data collection and analysis were conducted using a constant comparative process encompassing three phases: initial, focused and theoretical.ResultsWe identified important perspectives influencing nurses when patients with COPD are discharged from two pulmonary medical wards. We generated a substantial theory of how nurses integrate various perspectives into their handling of hospital discharge. The theory contains three discharge approaches: co‐creating, hesitating and socialising. The co‐creating approach focuses on patient and relative involvement and systematic task solution, embedded in a biopsychosocial process, aiming to achieve a safe and sustainable discharge. In contrast, the hesitating approach focuses on discharging patients in line with system requirements and colleagues' expectations. Finally, the socialising approach focuses on creating a pleasant discharge experience for patients and colleagues alike.ConclusionThis study illuminates three distinct approaches adopted by nurses when discharging a patient with COPD. The co‐creating process encompasses patient involvement and systematic task resolution, incorporating a biopsychosocial process. In contrast, the other approaches are more limited in scope: the hesitating approach aims for harmony and collegial consensus, while the socialising approach focuses on ensuring a pleasant discharge experience for everyone. Nurses should therefore be mindful of the approach they adopt and the values associated with it in order to optimise their management of hospital discharge processes.

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Clinical Outcome of a Cross-Sectorial Lung Team Treating Patients with COPD at High Risk of Exacerbation: A Randomized Controlled Trial

Cited by 5 publications

References 20 publications

Does affiliation to a cross‐sectorial lung team impact well‐being, health‐related quality of life, symptoms of anxiety and depression and patient involvement in patients with COPD? A randomised controlled trial

Does affiliation to a cross‐sectorial lung team impact well‐being, health‐related quality of life, symptoms of anxiety and depression and patient involvement in patients with COPD? A randomised controlled trial

Experiences of patients with advanced COPD affiliated to a cross‐sectorial outgoing lung team: A qualitative study

Preparing safe discharge in a complex practice: A qualitative study of nurses' approach to patients with COPD's hospital discharge from two pulmonary medicinal wards

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