Enhancing potential impact of hospital discharge interventions for patients with COPD: a qualitative systematic review
Abstract Background Patients with chronic obstructive pulmonary disease (COPD) are frequently readmitted to hospital resulting in avoidable healthcare costs. Many different interventions designed to reduce hospital readmissions are reported with limited evidence for effectiveness. Greater insight in...
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-09712-0 |
| _version_ | 1797795783708246016 |
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| author | Torbjørn Nygård David Wright Hamde Nazar Svein Haavik |
| author_facet | Torbjørn Nygård David Wright Hamde Nazar Svein Haavik |
| author_sort | Torbjørn Nygård |
| collection | DOAJ |
| description | Abstract Background Patients with chronic obstructive pulmonary disease (COPD) are frequently readmitted to hospital resulting in avoidable healthcare costs. Many different interventions designed to reduce hospital readmissions are reported with limited evidence for effectiveness. Greater insight into how interventions could be better designed to improve patient outcomes has been recommended. Aim To identify areas for optimisation within previously reported interventions provided to reduce COPD rehospitalisation to improve future intervention development. Methods A systematic review was conducted by searching Medline, Embase, CINAHL, PsycINFO, and CENTRAL in June 2022. Inclusion criteria were interventions provided to patients with COPD in the transition from hospital to home or community. Exclusion criteria were lack of empirical qualitative results, reviews, drug trials, and protocols. Study quality was assessed using the Critical Appraisal Skills Programme tool and results were synthesised thematically. Results A total of 2,962 studies were screened and nine studies included. Patients with COPD experience difficulties when transitioning from hospital to home. It is therefore important for interventions to facilitate a smooth transition process and give appropriate follow-up post-discharge. Additionally, interventions should be tailored for each patient, especially regarding information provided. Conclusion Very few studies specifically consider processes underpinning COPD discharge intervention implementation. There is a need to recognise that the transition itself creates problems, which require addressing, before introducing any new intervention. Patients report a preference for interventions to be individually adapted—in particular the provision of patient information. Whilst many intervention aspects were well received, feasibility testing may have enhanced acceptability. Patient and public involvement may address many of these concerns and greater use of process evaluations should enable researchers to learn from each other’s experiences. Trial registration The review was registered in PROSPERO with registration number CRD42022339523. |
| first_indexed | 2024-03-13T03:23:14Z |
| format | Article |
| id | doaj.art-79efa4d5efcb4bfda047e61091088b1a |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-13T03:23:14Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-79efa4d5efcb4bfda047e61091088b1a2023-06-25T11:12:49ZengBMCBMC Health Services Research1472-69632023-06-0123111310.1186/s12913-023-09712-0Enhancing potential impact of hospital discharge interventions for patients with COPD: a qualitative systematic reviewTorbjørn Nygård0David Wright1Hamde Nazar2Svein Haavik3Department of Clinical Science, University of BergenSchool of Healthcare, University of LeicesterSchool of Pharmacy, Newcastle UniversityDepartment of Clinical Science, University of BergenAbstract Background Patients with chronic obstructive pulmonary disease (COPD) are frequently readmitted to hospital resulting in avoidable healthcare costs. Many different interventions designed to reduce hospital readmissions are reported with limited evidence for effectiveness. Greater insight into how interventions could be better designed to improve patient outcomes has been recommended. Aim To identify areas for optimisation within previously reported interventions provided to reduce COPD rehospitalisation to improve future intervention development. Methods A systematic review was conducted by searching Medline, Embase, CINAHL, PsycINFO, and CENTRAL in June 2022. Inclusion criteria were interventions provided to patients with COPD in the transition from hospital to home or community. Exclusion criteria were lack of empirical qualitative results, reviews, drug trials, and protocols. Study quality was assessed using the Critical Appraisal Skills Programme tool and results were synthesised thematically. Results A total of 2,962 studies were screened and nine studies included. Patients with COPD experience difficulties when transitioning from hospital to home. It is therefore important for interventions to facilitate a smooth transition process and give appropriate follow-up post-discharge. Additionally, interventions should be tailored for each patient, especially regarding information provided. Conclusion Very few studies specifically consider processes underpinning COPD discharge intervention implementation. There is a need to recognise that the transition itself creates problems, which require addressing, before introducing any new intervention. Patients report a preference for interventions to be individually adapted—in particular the provision of patient information. Whilst many intervention aspects were well received, feasibility testing may have enhanced acceptability. Patient and public involvement may address many of these concerns and greater use of process evaluations should enable researchers to learn from each other’s experiences. Trial registration The review was registered in PROSPERO with registration number CRD42022339523.https://doi.org/10.1186/s12913-023-09712-0Chronic obstructive pulmonary diseaseSystematic reviewQualitative researchImplementation scienceHealth services |
| spellingShingle | Torbjørn Nygård David Wright Hamde Nazar Svein Haavik Enhancing potential impact of hospital discharge interventions for patients with COPD: a qualitative systematic review BMC Health Services Research Chronic obstructive pulmonary disease Systematic review Qualitative research Implementation science Health services |
| title | Enhancing potential impact of hospital discharge interventions for patients with COPD: a qualitative systematic review |
| title_full | Enhancing potential impact of hospital discharge interventions for patients with COPD: a qualitative systematic review |
| title_fullStr | Enhancing potential impact of hospital discharge interventions for patients with COPD: a qualitative systematic review |
| title_full_unstemmed | Enhancing potential impact of hospital discharge interventions for patients with COPD: a qualitative systematic review |
| title_short | Enhancing potential impact of hospital discharge interventions for patients with COPD: a qualitative systematic review |
| title_sort | enhancing potential impact of hospital discharge interventions for patients with copd a qualitative systematic review |
| topic | Chronic obstructive pulmonary disease Systematic review Qualitative research Implementation science Health services |
| url | https://doi.org/10.1186/s12913-023-09712-0 |
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