Evaluating the impact of post discharge callback on patients with COPD exacerbation
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a group of diseases that causes difficulty in breathing and is a leading cause of hospital admission and 30-day readmissions. A COPD 30-day readmission is defined as any return visit to the hospital resulting in admission following a discharge for COPD exacerbation treatment within 30 days. The purpose of this project was to evaluate the impact of a post-discharge callback within 72 hours of discharge on medication adherence, attendance to post discharge follow up clinic visit, and 30-day readmissions in COPD patients. A secondary purpose was to explore reasons why patients who are discharged with a diagnosis of COPD exacerbation, did or did not adhere to their medications and keep their post-discharge follow up clinic visit during the 30-days following hospital discharge. A comparison group of 10 subjects who did not receive a 3-day post discharge callback. The intervention group, including 9 subjects who received a post discharge callback. Four of the 10 individuals in the comparison group experienced a 30-day readmission compared to the two of the 9 individuals in the intervention group experiencing a 30-day readmission (Chi Square 0.69, p<0.41). Of the patients experiencing a 30-day readmission, four of six had poor medication adherence less than 80%. A post discharge clinic visit did not appear to have significance on readmission and medication adherence (Chi Square = 0.15, p<0.26). Patients that were readmitted reported lower perceived severity, benefit, and self-efficacy. High perceived benefit and cue to action were the Health Belief Model core concepts in order to describe medication adherence. Patients that did attend a post discharge clinic visit reported high perceived benefit and cue to action. Patients that did not attend a post discharge clinic visit reported low perceived severity, low perceived benefit, low perceived susceptibility, and high barriers.
