مورد إلكتروني
Reassessment of Home Oxygen Prescription after Hospitalization for Chronic Obstructive Pulmonary Disease. A Potential Target for Deimplementation.
| العنوان: | Reassessment of Home Oxygen Prescription after Hospitalization for Chronic Obstructive Pulmonary Disease. A Potential Target for Deimplementation. |
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| المؤلفون: | Spece, Laura J |
| المصدر: | Annals of the American Thoracic Society; vol 18, iss 3, 426-432; 2329-6933 |
| بيانات النشر: | eScholarship, University of California 2021-03-01 |
| تفاصيل مُضافة: | Spece, Laura J Epler, Eric M Duan, Kevin Donovan, Lucas M Griffith, Matthew F LaBedz, Stephanie Thakur, Neeta Wiener, Renda Soylemez Krishnan, Jerry A Au, David H Feemster, Laura C |
| نوع الوثيقة: | Electronic Resource |
| مستخلص: | Rationale: Hypoxemia associated with acute exacerbations of chronic obstructive pulmonary disease (COPD) often resolves with time. Current guidelines recommend that patients recently discharged with supplemental home oxygen after hospitalization should not have renewal of the prescription without assessment for hypoxemia. Understanding patterns of home oxygen reassessment is an opportunity to improve quality and value in home oxygen prescribing and may provide future targets for deimplementation.Objectives: We sought to measure the frequency of home oxygen reassessment within 90 days of hospitalization for COPD and determine the potential population eligible for deimplementation.Methods: We performed a cohort study of patients ≥40 years hospitalized for COPD at five Veterans Affairs facilities who were prescribed home oxygen at discharge. Our primary outcome was the frequency of reassessment within 90 days by oxygen saturation (SpO2) measurement. Secondary outcomes included the proportion of patients potentially eligible for discontinuation (SpO2 > 88%) and patients in whom oxygen was discontinued. Our primary exposures were treatment with long-acting bronchodilators, prior history of COPD exacerbation, smoking status, and pulmonary hypertension. We used a mixed-effects Poisson model to measure the association between patient-level variables and our outcome, clustered by site. We also performed a positive deviant analysis using chart review to uncover system processes associated with high-quality oxygen prescribing.Results: A total of 287 of 659 (43.6%; range 24.8-78.5% by site) patients had complete reassessment within 90 days. None of our patient-level exposures were associated with oxygen reassessment. Nearly half of those with complete reassessment were eligible for discontinuation on the basis of Medicare guidelines (43.2%; n = 124/287). When using the newest evidence available by the Long-Term Oxygen Treatment Trial, most of the cohort did not have resting |
| مصطلحات الفهرس: | Humans, Pulmonary Disease, Chronic Obstructive, Oxygen, Hospitalization, Cohort Studies, Aged, Medicare, United States, Prescriptions, COPD, care quality, oxygen, Lung, Clinical Trials and Supportive Activities, Chronic Obstructive Pulmonary Disease, Clinical Research, Respiratory, article |
| URL: | |
| الإتاحة: | Open access content. Open access content public |
| ملاحظة: | application/pdf Annals of the American Thoracic Society vol 18, iss 3, 426-432 2329-6933 |
| أرقام أخرى: | CDLER oai:escholarship.org:ark:/13030/qt9bh887ww qt9bh887ww https://escholarship.org/uc/item/9bh887wwTest https://escholarship.orgTest/ 1391597792 |
| المصدر المساهم: | UC MASS DIGITIZATION From OAIster®, provided by the OCLC Cooperative. |
| رقم الانضمام: | edsoai.on1391597792 |
| قاعدة البيانات: | OAIster |
| الوصف غير متاح. |