Study Protocol for a Hospital-to-Home Transitional Care for Older Adults Hospitalized with Chronic Obstructive Pulmonary Disease in South Korea: A Randomized Controlled Trial.
Heui-Sug JoWoo Jin KimYukyung ParkYu Seong HwangSeon-Sook HanYeon-Jeong HeoDahye MoonSu Kyoung KimChang Youl LeePublished in: International journal of environmental research and public health (2023)
Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition characterized by persistent inflammation in the airways, resulting in narrowing and obstruction of the air passages. The development of COPD is primarily attributed to long-term exposure to irritants, such as cigarette smoke and environmental pollutants. Among individuals hospitalized for exacerbations of COPD, approximately one in five is readmitted within 30 days of discharge or encounters immediate post-discharge complications, highlighting a lack of adequate preparedness for self-management. To address this inadequate preparedness, transitional care services (TCS) have emerged as a promising approach. Therefore, this study primarily aims to present a detailed protocol for a multi-site, single-blind, randomized, controlled trial (RCT) aimed at enhancing self-management competency and overall quality of life for patients with COPD through the provision of TCS, facilitated by a proficient Clinical Research Coordinator. The RCT intervention commenced in September 2022 and is set to conclude in December 2024, with a total of 362 COPD patients anticipated to be enrolled in the study. The intervention program encompasses various components, including an initial assessment during hospitalization, comprehensive self-management education, facilitation of social welfare connections, post-discharge home visits, and regular telephone monitoring. Furthermore, follow-up evaluations are conducted at both one month and three months after discharge to assess the effectiveness of the intervention in terms of preventing re-hospitalization, reducing acute exacerbations, and enhancing disease awareness among participants. The results of this study are expected to provide a basis for the development of TCS fee payment policies for future health insurance.
Keyphrases
- chronic obstructive pulmonary disease
- randomized controlled trial
- healthcare
- lung function
- health insurance
- public health
- cystic fibrosis
- palliative care
- quality improvement
- affordable care act
- study protocol
- systematic review
- primary care
- multiple sclerosis
- emergency department
- end stage renal disease
- chronic kidney disease
- oxidative stress
- intensive care unit
- climate change
- prognostic factors
- ejection fraction
- current status
- liver failure
- acute care
- life cycle