Original Research
Sunday, November 12, 2023
12:45 PM–02:15 PM
Abstract
Introduction: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality in the United States, and one in five COPD hospitalizations result in a readmission within 30 days. Pharmacists have been identified as key members of interdisciplinary teams to improve transitions of care for these patients.
Research Question or Hypothesis: What is the impact of a pharmacist-driven COPD care bundle on patient inhaler technique and 30-day hospital readmissions?
Study Design: Quasi-experimental, interventional study with a historical control group
Methods: A COPD care bundle was implemented for patients presenting with a COPD exacerbation from December 1, 2021 through February 28, 2022. A historical control group was created from patients who were discharged between December 1, 2020 through February 28, 2021. Interventions included medication/inhaler optimization, medication and disease state education, immunizations, smoking cessation, and medication coverage verification. Patient characteristics, pharmacist-driven interventions, and time required for the intervention were assessed descriptively. Inhaler technique was assessed before and after pharmacist education utilizing standardized rubrics. The percentage change in inhaler scores was assessed with a Wilcoxon signed-rank test. Readmission outcomes will be analyzed using a chi-squared test.
Results: There were 30 patients in the intervention group and 46 in the control group. There were 104 interventions requiring provider collaboration, of which 84 (81%) were accepted. A median (interquartile range, IQR) of 46 (37-55) minutes was spent per patient in the intervention group. At baseline, patients scored a median of 84.6% (75-100) of steps correctly across all inhaler device types. After pharmacist education, patient scores increased to a median of 100% (92.3-100) (P<0.0001). There were eight (26.7%) 30-day all-cause readmission rates in the intervention group and fifteen (32.6%) in the control group (P=0.58).
Conclusion: Most pharmacist recommendations were accepted by providers. Medication education led to improved understanding of inhaler technique, but the intervention did not reduce 30-day readmission rates.
Presenting Author
Collin M. Clark PharmD, BCPS, BCGPUniversity at Buffalo Jacobs School of Medicine and Biomedical Sciences
Authors
Brian Kersten PharmD, BCPS, BCCCP
Buffalo General Medical Center
Maggie Lycouras PharmD, BCPS
Buffalo General Medical Center
Nicole Cieri-Hutcherson PharmD, BCPS, NCMP
University at Buffalo School of Pharmacy and Pharmaceutical Sciences