Category: Federal Forum Posters
Purpose: Primarily, identify fragments in care of current Chronic Obstructive Pulmonary Disease (COPD) follow-up post-hospitalization and identify characteristics of patients and their medication regimens who may benefit from appointments with pharmacists in an ambulatory care setting. Secondarily, assess inpatient COPD management for compliance with current COPD guidelines as recommended duration of antibiotic and steroid therapy has decreased.
Methods: Electronic medical records of patients with primary discharge diagnosis of COPD from August 2017- August 2018 will be reviewed for the following information: demographics (age, gender, race, length of stay, time spent in the ICU), duration of antibiotics and systemic corticosteroids for exacerbations, inhaler adherence prior to admission, complexity of inhaler and medication regimen at discharge, 30-day outcomes (hospital readmission, emergency department visit, unscheduled primary care visit), and outpatient follow-up. Regarding systemic corticosteroids and antibiotics, appropriate duration of therapy will be defined as 5 to 7 days, as recommended by the current Global Initiative for Chronic Obstructive Lung Disease guidelines, and will include both inpatient and discharge regimens. Documentation of inhaler education and COPD home action plan will be identified via chart review of notes. Adherence will be assessed by reviewing inhaler fill history during year prior to admission. Assessment of complexity of inhaler and medication regimen will include evaluating type and frequency of inhaler administration, total number of medications, and number of medication changes at discharge. Number of days from discharge to follow-up and type of follow-up will be identified. Inhalers on discharge will be evaluated for appropriateness in patients with documented pulmonary function tests prior to hospitalization.
Results: not applicable
Conclusion: not applicable
Andrea Hegland– PGY1 Pharmacy Resident, Minneapolis VA Health Care System, Bloomington, MN