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A multicenter randomized trial for the effectiveness of structured discharge and follow-up protocol on readmission rate in COPD patients receiving LTOT/NIV: one-year interim analysis.

Background: Readmission to the hospital is one of the most important problems in chronic obstructive pulmonary disease (COPD) patients receiving long-term oxygen therapy (LTOT) and noninvasive ventilation (NIV). The aim of this trial is to find out whether a structured discharge and follow-up protocol reduce the rate of unplanned, COPD-related hospital readmissions over 90 days in patients receiving LTOT and/or NIV. Herein the results of the interim analysis are presented. Method: The study was planned as Turkish Thoracic Society and GARD-Turkey project and carried out 10 centers throughout Turkey. COPD patients who were prescribed LTOT and/or NIV were included and randomized to either intervention or control arm. The intervention mainly consisted of detailed training before discharge and close follow-up strategy. Control patients received usual care, which consisted of basic education of the patient about the therapies. Results: A total of 112 patients were included in the study within the first year and data analysis was performed in 65 patients (control group 26, intervention group 39) who finished the study period. It was observed that there was no difference between the study groups for subjective outcomes and the median duration of LTOT/NIV use. The hospital readmission and hospitalization rates were 30.7% and 11.5% in control group and 15.4% and 5.1% in the intervention group, respectively. Conclusion: The preliminary results showed that structured discharge and follow up protocol might be a helpful approach for prevention of recurrent admissions in COPD patients with chronic respiratory failure