Browsing by Author "Fried, D. Michiko"

Now showing 1 - 1 of 1
  • Thumbnail Image
    Item
    The Effectiveness of Action Plan Implementation by Primary Care Providers on the Frequency of Preventable Acute Care Visits for Adults with COPD
    (2018-09-12) Fried, D. Michiko; Davis, Alice; Thornett, Tracy; Van Hoose, Diane
    COPD is the 3rd leading cause of death in the U.S. and 4th in the world. The economic burden of COPD in the U.S. in 2010 was almost $50 billion, which included almost $30 billion in direct healthcare costs due primarily to hospitalizations following exacerbations. Selfmanagement skills fostered in a patient-centered primary care setting are essential for symptom control and the prevention or early detection of the exacerbations and complications that lead to healthcare utilization. However, adequate self-management is difficult due to the complex heterogeneity of COPD. Poor symptom control results in more frequent but preventable hospital visits and an accelerated functional decline. Patients with COPD often have increased health risks due to chronic co-morbid conditions and wide variations in clinical, functional, and behavioral patient presentations that challenge practitioners to develop, modify, and reinforce components of effective care plans whose success depends upon patient self-management. This paper describes the design and implementation of BREATHE for a Better Life, a primary care pilot program for adults focused on self-management. As a practice inquiry project (PIP), BREATHE sought to demonstrate the effectiveness of an action plan on controlling the symptoms of COPD or COPD with asthma to optimize daily function and quality of life. Quality measures included the frequency of acute medical visits for respiratory complaints, spirometry values, and COPD Assessment Test (CAT) scores tracked over a two-month implementation period. Despite the brief nature of the intervention, results revealed gaps in care, provided opportunities for workflow improvements, and substantiated the need to evaluate and incorporate patients’ self-perceptions of health into a comprehensive care plan. The PIP’s supervising physician committed to continuing BREATHE for a minimum of one year and will continue to collect data in anticipation of significant results to support its value and sustainability.