Order Sets Help Decrease COPD Hospitalization

Order Sets Help Decrease COPD Hospitalization

The use of order sets by physicians for the management of chronic obstructive disease (COPD) is able to reduce hospitalization time, according to a recent study that evaluated the use of the system in Canada. Patients with worsening disease who were treated through the sets spent less time in the hospital compared to patients whose doctors did not follow the regimen.

The order sets include a series of checklist recommendations designed to assist physicians in the decision making process about the most appropriate course of care in COPD patients. COPD is responsible for the development of chronic bronchitis and emphysema, and is a leading cause of death worldwide. Patients with COPD make frequent trips to the hospital, and in Canada it is the leading cause of hospitalizations.

Investigator Samir Gupta focused on analyzing for the first time the impact of order sets on patients with worsening COPD. The results of the study were published in the Canadian Respiratory Journal in an article entitled, “Gaps in the inpatient management of chronic obstructive pulmonary disease exacerbation and impact of an evidence-based order set.”

“Using order sets to manage worsening COPD can lead to better medical care and better results for patients,” said Gupta, a respirologist at St. Michael’s Hospital, in a press release. “By providing doctors with the best, evidence-based information at the point in time when they are deciding on medications and tests for their patients, we can improve doctors’ adherence to best practices.”

During the study, researchers encouraged both physicians and other members of the hospital staff to use the order set, which provided comprehensive admission instructions. The checklist was created by a team from the respirology and internal medicine wards at St. Michael’s, particularly focusing on patients who were admitted to the hospital due to worsening COPD.

According to the study results, the length of patients’ average hospital stay decreased approximately two-and-a-half days in cases where physicians used the order sets. “This is a dramatic drop, and points to one of the key, positive findings in our research,” continued the researcher. “The faster we can get patients home and breathing easier, the better for our patients and for our health-care system.”

In addition, Gupta’s team also discovered that the checklist led to an increase in the number of patients administered with corticosteroids, a treatment that prevents patients from needing to go to the intensive care unit, as it can control inflammation in the lungs that develops due to the disease. Regarding medication, the investigator also found that more patients were treated with proper antibiotics that led to fewer cases of over-treatment and antibiotic resistance, according to the order sets.

“At the end of the day, this is all about improving care and outcomes for patients,” concluded Gupta. “Our next step is to advocate for these order sets to be implemented across the health-care system, to ensure that these patients receive best evidence-based and standardized care.”

Hospitalizations of COPD patients is an ongoing concern, and the COPD Foundation has also launched a COPD Praxis program, focused on bringing together the joint efforts of academics, healthcare providers, and industry leaders to reduce hospital readmissions due to COPD exacerbation or symptom flare ups. Under the Praxis program, the foundation hosted the 2nd Readmission Summit, by the beginning year, in collaboration with Sunovion Pharmaceuticals, one of the primary sponsors of the Praxis program.

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