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Management of acute COPD exacerbations in Australia: do we follow the guidelines?

Cousins, JL, Wood-Baker, R, Wark, PAB, Yang, IA, Gibson, PG, Hutchinson, Anastasia, Sajkov, D, Hiles, SA, Samuel, S and McDonald, VM 2020, Management of acute COPD exacerbations in Australia: do we follow the guidelines?, ERJ Open Research, vol. 6, no. 2, pp. 1-9, doi: 10.1183/23120541.00270-2019.


Title Management of acute COPD exacerbations in Australia: do we follow the guidelines?
Author(s) Cousins, JL
Wood-Baker, R
Wark, PAB
Yang, IA
Gibson, PG
Hutchinson, AnastasiaORCID iD for Hutchinson, Anastasia orcid.org/0000-0002-0014-689X
Sajkov, D
Hiles, SA
Samuel, S
McDonald, VM
Journal name ERJ Open Research
Volume number 6
Issue number 2
Article ID 270
Start page 1
End page 9
Total pages 9
Publisher European Respiratory Society
Place of publication Lausanne, Switzerland
Publication date 2020-04-19
ISSN 2312-0541
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Respiratory System
OBSTRUCTIVE PULMONARY-DISEASE
EMERGENCY-DEPARTMENT
CARE
ADHERENCE
SPIROMETRY
AUDIT
Summary Objective: We aimed to assess adherence to the Australian national guideline (COPD-X) against audited practice, and to document the outcomes of patients hospitalised with an acute exacerbation of chronic obstructive pulmonary disease (COPD) at discharge and 28 days after. Methods A prospective clinical audit of COPD hospital admission from five tertiary care hospitals in five states of Australia was conducted. Post-discharge follow-up was conducted via telephone to assess for readmission and health status. Results: There were 207 admissions for acute exacerbation (171 patients; mean 70.2 years old; 50.3% males). Readmission rates at 28 days were 25.4%, with one (0.6%) death during admission and eight (6.1%) post-discharge within 28 days. Concordance to the COPD-X guidance was variable; 22.7% performed spirometry, 81.1% had blood gases collected when forced expiratory volume in 1 s was <1 L, 99.5% had chest radiography performed, 95.1% were prescribed systemic corticosteroids and 95% were prescribed antibiotic therapy. There were 89.1% given oxygen therapy and 92.6% when arterial oxygen tension was <80 mmHg; 65.6% were given ventilatory assistance when pH was <7.35. Only 32.4% were referred to pulmonary rehabilitation but 76.8% had general practitioner follow-up arranged. Conclusion: When compared against clinical practice guidelines, we found important gaps in management of patients admitted with COPD throughout tertiary care centres in Australia. Strategies to improve guideline uptake are needed to optimise care.
Language eng
DOI 10.1183/23120541.00270-2019
Field of Research 110299 Cardiorespiratory Medicine and Haematology not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2020, ERS
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30117257

Document type: Journal Article
Collections: Faculty of Health
School of Nursing and Midwifery
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.