Integrated care prevents hospital isations for exacerbations in COPD patients. Casas, A., Troosters, T., Garcia-Aymerich, J., Roca, J., Hernandez, C., Alonso, A., del Pozo, F., de Toledo, P., Anto, J. M., Rodriguez-Roisin, R., & Decramer, M. European Respiratory Journal, 28(1):123--130, July, 2006.
abstract   bibtex   
Hospital admissions due to chronic obstructive pulmonary disease (COPD) exacerbations have a major impact on the disease evolution and costs. The current authors postulated that a simple and well-standardised, low-intensity integrated care intervention can be effective to prevent such hospitalisations. Therefore, 155 exacerbated COPD patients (17% females) were recruited after hospital discharge from centres in Barcelona (Spain) and Leuven (Belgium). They were randomly assigned to either integrated care (IC; n=65; age mean +/- SD 70 +/- 9 yrs; forced expiratory volume in one second (FEV1) 1.1 +/- 0.5 L, 43% predicted) or usual care (UC; n =90; age 72 +/- 9 yrs; FEV1 1.1 +/- 0.05 L, 41% pred). The IC intervention consisted of an individually tailored care plan upon discharge shared with the primary care team, as well as accessibility to a specialised nurse case manager through a web-based call centre. After 12 months' follow-up, IC showed a lower hospitalisation rate (1.5 +/- 2.6 versus 2.1 +/- 3.1) and a higher percentage of patients without re-admissions (49 versus 31%) than UC without differences in mortality (19 versus 16%, respectively). In conclusion, this trial demonstrates that a standardised integrated care intervention, based on shared care arrangements among different levels of the system with support of information technologies, effectively prevents hospitalisations for exacerbations in chronic obstructive pulmonary disease patients.
@article{ deToledo-2006a,
  author = {Casas, A. and Troosters, T. and Garcia-Aymerich, J. and Roca, J.
	and Hernandez, C. and Alonso, A. and del Pozo, F. and de Toledo,
	P. and Anto, J. M. and Rodriguez-Roisin, R. and Decramer, M.},
  title = {Integrated care prevents hospital isations for exacerbations in COPD
	patients},
  journal = {European Respiratory Journal},
  year = {2006},
  volume = {28},
  pages = {123--130},
  number = {1},
  month = {July},
  ca = {CHRONIC Project},
  di = {10.1183/09031936.06.00063205},
  sn = {0903-1936},
  tc = {74},
  ut = {WOS:000239066500019},
  z9 = {74},
  abstract = {Hospital admissions due to chronic obstructive pulmonary disease (COPD)
	exacerbations have a major impact on the disease evolution and costs.
	The current authors postulated that a simple and well-standardised,
	low-intensity integrated care intervention can be effective to prevent
	such hospitalisations. Therefore, 155 exacerbated COPD patients (17%
	females) were recruited after hospital discharge from centres in
	Barcelona (Spain) and Leuven (Belgium). They were randomly assigned
	to either integrated care (IC; n=65; age mean +/- SD 70 +/- 9 yrs;
	forced expiratory volume in one second (FEV1) 1.1 +/- 0.5 L, 43%
	predicted) or usual care (UC; n =90; age 72 +/- 9 yrs; FEV1 1.1 +/-
	0.05 L, 41% pred). The IC intervention consisted of an individually
	tailored care plan upon discharge shared with the primary care team,
	as well as accessibility to a specialised nurse case manager through
	a web-based call centre. After 12 months' follow-up, IC showed a
	lower hospitalisation rate (1.5 +/- 2.6 versus 2.1 +/- 3.1) and a
	higher percentage of patients without re-admissions (49 versus 31%)
	than UC without differences in mortality (19 versus 16%, respectively).
	In conclusion, this trial demonstrates that a standardised integrated
	care intervention, based on shared care arrangements among different
	levels of the system with support of information technologies, effectively
	prevents hospitalisations for exacerbations in chronic obstructive
	pulmonary disease patients.}
}
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