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Aboumatar H, Naqibuddin M, Chung S, Adebowale H, Bone L, Brown T, Cooper LA, Gurses AP, Knowlton A, Kurtz D, Piet L, Putcha N, Rand C, Roter D, Shattuck E, Sylvester C, Urteaga-Fuentes A, Wise R, Wolff JL, Yang T, Hibbard J, Howell E, Myers M, Shea K, Sullivan J, Syron L, Wang NY, Pronovost P. Better Respiratory Education and Treatment Help Empower (BREATHE) study: Methodology and baseline characteristics of a randomized controlled trial testing a transitional care program to improve patient-centered care delivery among chronic obstructive pulmonary disease patients. Contemp Clin Trials 2017; 62:159-167. [PMID: 28887069 DOI: 10.1016/j.cct.2017.08.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 08/23/2017] [Accepted: 08/25/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of hospitalizations. Interventional studies focusing on the hospital-to-home transition for COPD patients are few. In the BREATHE (Better Respiratory Education and Treatment Help Empower) study, we developed and tested a patient and family-centered transitional care program that helps prepare hospitalized COPD patients and their family caregivers to manage COPD at home. METHODS In the study's initial phase, we co-developed the BREATHE transitional care program with COPD patients, family-caregivers, and stakeholders. The program offers tailored services to address individual patients' needs and priorities at the hospital and for 3months post discharge. We tested the program in a single-blinded RCT with 240 COPD patients who were randomized to receive the program or 'usual care'. Program participants were offered the opportunity to invite a family caregiver, if available, to enroll with them into the study. The primary outcomes were the combined number of COPD-related hospitalizations and Emergency Department (ED) visits per participant at 6months post discharge, and the change in health-related quality of life over the 6months study period. Other measures include 'all cause' hospitalizations and ED visits; patient activation; self-efficacy; and, self-care behaviors. DISCUSSION Unlike 1month transitional care programs that focus on patients' post-acute care needs, the BREATHE program helps hospitalized COPD patients manage the post discharge period as well as prepare them for long term self-management of COPD. If proven effective, this program may offer a timely solution for hospitals in their attempts to reduce COPD rehospitalizations.
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Affiliation(s)
- H Aboumatar
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States; Division of General Internal Medicine, Dept. of Medicine, Johns Hopkins University School of Medicine, United States; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, United States.
| | - M Naqibuddin
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States
| | - S Chung
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States
| | - H Adebowale
- Johns Hopkins Bayview Medical Center, United States
| | - L Bone
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, United States; Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - T Brown
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States
| | - L A Cooper
- Division of General Internal Medicine, Dept. of Medicine, Johns Hopkins University School of Medicine, United States; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, United States
| | - A P Gurses
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States; Anesthesiology and Critical Care, The Johns Hopkins School of Medicine, United States; Division of Health Sciences Informatics, The Johns Hopkins School of Medicine, United States; Malone Center for Engineering in Healthcare, Whiting School of Engineering, Johns Hopkins University, United States
| | - A Knowlton
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - D Kurtz
- Johns Hopkins Bayview Medical Center, United States
| | - L Piet
- Johns Hopkins Bayview Medical Center, United States
| | - N Putcha
- Pulmonary and Critical Care Medicine, The Johns Hopkins School of Medicine, United States
| | - C Rand
- Pulmonary and Critical Care Medicine, The Johns Hopkins School of Medicine, United States
| | - D Roter
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, United States
| | - E Shattuck
- Patient Advocate/Co-investigator, BREATHE Project, United States
| | - C Sylvester
- Johns Hopkins Bayview Medical Center, United States
| | - A Urteaga-Fuentes
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States
| | - R Wise
- Pulmonary and Critical Care Medicine, The Johns Hopkins School of Medicine, United States
| | - J L Wolff
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - T Yang
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States
| | - J Hibbard
- Health Policy Research Group, University of Oregon
| | - E Howell
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States; Johns Hopkins Bayview Medical Center, United States
| | - M Myers
- Johns Hopkins Home Care Group, United States
| | - K Shea
- Johns Hopkins Bayview Medical Center, United States
| | | | - L Syron
- Johns Hopkins Home Care Group, United States
| | - Nae-Yuh Wang
- Division of General Internal Medicine, Dept. of Medicine, Johns Hopkins University School of Medicine, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, United States
| | - P Pronovost
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States; Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, United States; Anesthesiology and Critical Care, The Johns Hopkins School of Medicine, United States
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