TY - JOUR
T1 - Patient and Health Care Provider Perspectives on Potential Preventability of Hospital Admission for Acute Exacerbation of Chronic Obstructive Pulmonary Disease
T2 - A Qualitative Study
AU - Leenders, Anna
AU - Sportel, Esther
AU - Poppink, Elise
AU - van Beurden, Wendy
AU - van der Valk, Paul
AU - Brusse-Keizer, Marjolein
N1 - Publisher Copyright: © 2022 Leenders et al.
PY - 2022
Y1 - 2022
N2 - Purpose: Chronic obstructive pulmonary disease (COPD) is a highly prevalent chronic disease partly characterised by the occurrence of acute exacerbations (AECOPD). The need for hospital admissions for COPD exacerbations could theoretically be decreased through timely and appropriate outpatient care or self-management. The aim of this study is to explore and compare patients’ and health care providers’ (HCP) perspectives on the potential preventability of COPD hospitalisations and to identify strategies to prevent unnecessary hospitalisations. Patients and Methods: Semi-structured interviews were conducted with patients admitted for an AECOPD (N = 11), HCPs on the respiratory ward (N = 11), and treating pulmonologists (N = 10). Interviews were transcribed verbatim and analysed using thematic content analysis. Results: Patient and HCP perspectives on the potential preventability of hospital admissions for AECOPD often conflict. The kappa coefficients were −0.18 [95% CI: −0.46–0.11] for patients and pulmonologists and −0.28 [95% CI: −0.80–0.21] for patients and HCPs, which indicates poor agreement. The kappa coefficient for pulmonologists and HCPs was 0.14 [95% CI: −0.13–0.41], which indicates slight agreement. Patient and HCP factors that could potentially prevent hospitalisation for AECOPD were identified, including timely calling for help, recognizing and acting on symptoms, and receiving instruction about COPD, including treatment and action plans. Conclusion: Patients and their HCPs have different beliefs about the potential preventability of AECOPD hospitalisations. Most patients and HCPs mentioned factors that potentially could have led to a different outcome for the current AECOPD or that could impact the patient’s health status and treatment of AECOPDs in the future. The factors identified in this study indicate that shared decision making is crucial to center the patient’s perspective and individual needs and to provide timely treatment or prevention of AECOPD, thereby potentially decreasing hospital admission rates.
AB - Purpose: Chronic obstructive pulmonary disease (COPD) is a highly prevalent chronic disease partly characterised by the occurrence of acute exacerbations (AECOPD). The need for hospital admissions for COPD exacerbations could theoretically be decreased through timely and appropriate outpatient care or self-management. The aim of this study is to explore and compare patients’ and health care providers’ (HCP) perspectives on the potential preventability of COPD hospitalisations and to identify strategies to prevent unnecessary hospitalisations. Patients and Methods: Semi-structured interviews were conducted with patients admitted for an AECOPD (N = 11), HCPs on the respiratory ward (N = 11), and treating pulmonologists (N = 10). Interviews were transcribed verbatim and analysed using thematic content analysis. Results: Patient and HCP perspectives on the potential preventability of hospital admissions for AECOPD often conflict. The kappa coefficients were −0.18 [95% CI: −0.46–0.11] for patients and pulmonologists and −0.28 [95% CI: −0.80–0.21] for patients and HCPs, which indicates poor agreement. The kappa coefficient for pulmonologists and HCPs was 0.14 [95% CI: −0.13–0.41], which indicates slight agreement. Patient and HCP factors that could potentially prevent hospitalisation for AECOPD were identified, including timely calling for help, recognizing and acting on symptoms, and receiving instruction about COPD, including treatment and action plans. Conclusion: Patients and their HCPs have different beliefs about the potential preventability of AECOPD hospitalisations. Most patients and HCPs mentioned factors that potentially could have led to a different outcome for the current AECOPD or that could impact the patient’s health status and treatment of AECOPDs in the future. The factors identified in this study indicate that shared decision making is crucial to center the patient’s perspective and individual needs and to provide timely treatment or prevention of AECOPD, thereby potentially decreasing hospital admission rates.
KW - COPD exacerbation
KW - hospitalisation
KW - patient and provider preferences
KW - prevention
UR - http://www.scopus.com/inward/record.url?scp=85143524923&partnerID=8YFLogxK
U2 - https://doi.org/10.2147/PPA.S380862
DO - https://doi.org/10.2147/PPA.S380862
M3 - Article
C2 - 36531300
SN - 1177-889X
VL - 16
SP - 3207
EP - 3220
JO - Patient preference and adherence
JF - Patient preference and adherence
ER -