The impact of a personalised action plan delivered at discharge to patients with COPD on readmissions: a pilot study

Annette Hegelund, Ingrid Charlotte Andersen, Marianne N. Andersen, Uffe Bodtger

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background: Self-management interventions in COPD, including action plans, have the potential to increase quality of life and to reduce respiratory-related hospitalisations. However, knowledge is still sparse of the effectiveness of a personally tailored action plan introduced at or right after discharge from hospital. Aim: This pilot study aimed to test whether a personalised, stepwise action plan supported with a short instruction provided at or postdischarge after an acute exacerbation in chronic obstructive pulmonary disease admission as an addition to usual care reduces readmissions and symptom burden, including anxiety and depression levels at 3-month follow-up. Methods: The study was carried out in a randomised controlled design with follow-up after 3 months. In all, 75 participants were randomly assigned to either an intervention group that received an action plan, including the COPD Assessment Test (CAT), or to a control group that received usual care. The incidence of COPD-related readmissions was measured as the primary outcome. Results: Compared to the control group, the action plan group significantly reduced the incidence of readmissions. The action plan group showed a trend towards a significant decrease in HADS-depression, but none in HADS-anxiety. Significant improvements in CAT scores were observed for the participants in the intervention group. Only inferior minor differences were found in use of inhalation therapy. Conclusions: A personally tailored action plan introduced at or postdischarge combined with follow-up support is an effective self-management tool to support recovery and to reduce unnecessary readmissions. In future follow-up care, the healthcare professional must initiate the action plan at discharge and immediately after having the opportunity to follow the patient at home. This might require healthcare professionals working across healthcare sectors, who support patients until they have the needed confidence and competence in using the plan.

Original languageEnglish
JournalScandinavian Journal of Caring Sciences
ISSN0283-9318
DOIs
Publication statusE-pub ahead of print - 21. Dec 2019

Fingerprint

Patient Discharge
Chronic Obstructive Pulmonary Disease
Depression
Delivery of Health Care
Control Groups
Health Care Sector
Incidence
Mental Competency
Quality of Life
4-amino-4'-hydroxylaminodiphenylsulfone

Keywords

  • COPD
  • COPD Assessment Test (CAT)
  • anxiety
  • cross-sectorial
  • depression
  • discharge
  • personalised action plan
  • questionnaire
  • readmission
  • self-management

Cite this

@article{be6dd10c576f41c8bf2f2b8796688821,
title = "The impact of a personalised action plan delivered at discharge to patients with COPD on readmissions: a pilot study",
abstract = "Background: Self-management interventions in COPD, including action plans, have the potential to increase quality of life and to reduce respiratory-related hospitalisations. However, knowledge is still sparse of the effectiveness of a personally tailored action plan introduced at or right after discharge from hospital. Aim: This pilot study aimed to test whether a personalised, stepwise action plan supported with a short instruction provided at or postdischarge after an acute exacerbation in chronic obstructive pulmonary disease admission as an addition to usual care reduces readmissions and symptom burden, including anxiety and depression levels at 3-month follow-up. Methods: The study was carried out in a randomised controlled design with follow-up after 3 months. In all, 75 participants were randomly assigned to either an intervention group that received an action plan, including the COPD Assessment Test (CAT), or to a control group that received usual care. The incidence of COPD-related readmissions was measured as the primary outcome. Results: Compared to the control group, the action plan group significantly reduced the incidence of readmissions. The action plan group showed a trend towards a significant decrease in HADS-depression, but none in HADS-anxiety. Significant improvements in CAT scores were observed for the participants in the intervention group. Only inferior minor differences were found in use of inhalation therapy. Conclusions: A personally tailored action plan introduced at or postdischarge combined with follow-up support is an effective self-management tool to support recovery and to reduce unnecessary readmissions. In future follow-up care, the healthcare professional must initiate the action plan at discharge and immediately after having the opportunity to follow the patient at home. This might require healthcare professionals working across healthcare sectors, who support patients until they have the needed confidence and competence in using the plan.",
keywords = "COPD, COPD Assessment Test (CAT), anxiety, cross-sectorial, depression, discharge, personalised action plan, questionnaire, readmission, self-management",
author = "Annette Hegelund and Andersen, {Ingrid Charlotte} and Andersen, {Marianne N.} and Uffe Bodtger",
year = "2019",
month = "12",
day = "21",
doi = "10.1111/scs.12798",
language = "English",
journal = "Scandinavian Journal of Caring Sciences",
issn = "0283-9318",
publisher = "Wiley-Blackwell",

}

The impact of a personalised action plan delivered at discharge to patients with COPD on readmissions : a pilot study. / Hegelund, Annette; Andersen, Ingrid Charlotte; Andersen, Marianne N.; Bodtger, Uffe.

In: Scandinavian Journal of Caring Sciences, 21.12.2019.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - The impact of a personalised action plan delivered at discharge to patients with COPD on readmissions

T2 - a pilot study

AU - Hegelund, Annette

AU - Andersen, Ingrid Charlotte

AU - Andersen, Marianne N.

AU - Bodtger, Uffe

PY - 2019/12/21

Y1 - 2019/12/21

N2 - Background: Self-management interventions in COPD, including action plans, have the potential to increase quality of life and to reduce respiratory-related hospitalisations. However, knowledge is still sparse of the effectiveness of a personally tailored action plan introduced at or right after discharge from hospital. Aim: This pilot study aimed to test whether a personalised, stepwise action plan supported with a short instruction provided at or postdischarge after an acute exacerbation in chronic obstructive pulmonary disease admission as an addition to usual care reduces readmissions and symptom burden, including anxiety and depression levels at 3-month follow-up. Methods: The study was carried out in a randomised controlled design with follow-up after 3 months. In all, 75 participants were randomly assigned to either an intervention group that received an action plan, including the COPD Assessment Test (CAT), or to a control group that received usual care. The incidence of COPD-related readmissions was measured as the primary outcome. Results: Compared to the control group, the action plan group significantly reduced the incidence of readmissions. The action plan group showed a trend towards a significant decrease in HADS-depression, but none in HADS-anxiety. Significant improvements in CAT scores were observed for the participants in the intervention group. Only inferior minor differences were found in use of inhalation therapy. Conclusions: A personally tailored action plan introduced at or postdischarge combined with follow-up support is an effective self-management tool to support recovery and to reduce unnecessary readmissions. In future follow-up care, the healthcare professional must initiate the action plan at discharge and immediately after having the opportunity to follow the patient at home. This might require healthcare professionals working across healthcare sectors, who support patients until they have the needed confidence and competence in using the plan.

AB - Background: Self-management interventions in COPD, including action plans, have the potential to increase quality of life and to reduce respiratory-related hospitalisations. However, knowledge is still sparse of the effectiveness of a personally tailored action plan introduced at or right after discharge from hospital. Aim: This pilot study aimed to test whether a personalised, stepwise action plan supported with a short instruction provided at or postdischarge after an acute exacerbation in chronic obstructive pulmonary disease admission as an addition to usual care reduces readmissions and symptom burden, including anxiety and depression levels at 3-month follow-up. Methods: The study was carried out in a randomised controlled design with follow-up after 3 months. In all, 75 participants were randomly assigned to either an intervention group that received an action plan, including the COPD Assessment Test (CAT), or to a control group that received usual care. The incidence of COPD-related readmissions was measured as the primary outcome. Results: Compared to the control group, the action plan group significantly reduced the incidence of readmissions. The action plan group showed a trend towards a significant decrease in HADS-depression, but none in HADS-anxiety. Significant improvements in CAT scores were observed for the participants in the intervention group. Only inferior minor differences were found in use of inhalation therapy. Conclusions: A personally tailored action plan introduced at or postdischarge combined with follow-up support is an effective self-management tool to support recovery and to reduce unnecessary readmissions. In future follow-up care, the healthcare professional must initiate the action plan at discharge and immediately after having the opportunity to follow the patient at home. This might require healthcare professionals working across healthcare sectors, who support patients until they have the needed confidence and competence in using the plan.

KW - COPD

KW - COPD Assessment Test (CAT)

KW - anxiety

KW - cross-sectorial

KW - depression

KW - discharge

KW - personalised action plan

KW - questionnaire

KW - readmission

KW - self-management

U2 - 10.1111/scs.12798

DO - 10.1111/scs.12798

M3 - Journal article

C2 - 31865631

JO - Scandinavian Journal of Caring Sciences

JF - Scandinavian Journal of Caring Sciences

SN - 0283-9318

ER -