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Keeping COPD patients out of hospital

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Living Well education program helps keep patients out of hospital

A program at (RVHS) is helping to keep patients with chronic obstructive pulmonary disease (COPD) out of hospital.

RVHS offers an education and self-management clinic on COPD for outpatients as part of its Living Well chronic disease education program that also includes clinics for asthma, osteoporosis, arthritis, chronic pain, hypertension, and smoking cessation. The COPD clinic was started in March 2013, based on a module from the Ontario Lung Association and input from the RVHS respirology team.

COPD is a chronic disease that limits airflow to and from the lungs, causing shortness of breath and other breathing problems. The Canadian Institute of Health Information (CIHI) states that COPD now accounts for the highest rate of hospital admission among major chronic illnesses in Canada. Further, hospital readmissions are higher among COPD patients than any other chronic illness. Rouge Valley’s COPD clinic, which teaches patients self-management of their condition, is helping to bring these rates down.

“The goal of this clinic is for patients to move towards a comprehensive and proactive approach to chronic disease prevention and management. Patients can learn techniques that allow them a much better quality of life while living with their condition. With triggers under control, emergency visits and the subsequent readmissions can decrease,” says Amber Curry, manager, inpatient surgery, ambulatory care unit, pre-admit and fracture clinic, RVHS.

Most of the participants who come to the education clinic are on a cycle of emergency department visits and/or being readmitted to hospital. Staff and physicians refer these patients to Susan Bradbury, a registered practical nurse who runs the Living Well program. She visits patients while in hospital to inform them about the COPD clinic and the benefits of learning to manage the condition successfully. The majority of these patients attend, sometimes with family members who wish to learn how to help their loved ones.

The clinic has proven to be life-changing, helping patients to break the cycle of continual hospital visits. Since September 2014, only one out of 82 patients was readmitted to hospital for a COPD exacerbation within 30 days after completing the COPD program, and only six were readmitted within 90 days.

Janet Gayle is one of those COPD clinic graduates who has learned how to get her breathing under control and has not needed to go back to the hospital. “Before I went to the clinic, I was having trouble breathing when I was doing anything. Every time I got a cold, it would go straight to my lungs, and I’d be hospitalized,” says Gayle.

An asthma sufferer for over 30 years, she was diagnosed with COPD in November of 2012. She lived a restricted life, not able to do housework or climb the stairs without gasping for breath. Sometimes fragrances and perfumes that her co-workers wore would prompt an attack, or she could not go to her son’s hockey games because the cold air in the arena would make it difficult to breathe. Even enjoying herself out with friends was hard, as laughing would bring on a coughing fit.

By participating in the clinic, Gayle learned the best way to get oxygen into her compromised lungs. She also learned how to manage environmental triggers and her medications. And, in the two years since she finished clinic, she has not needed to go to the emergency department.

Rouge Valley respirologist Dr. George Philteos, who is involved in the COPD program, says: “I have been very pleased with the feedback I have received from patients. They have a better understanding of their disease and have learned valuable coping strategies that impact their quality of life.”

Gayle agrees. “You can live with your COPD, and you can have a fulfilling life, but have to know how. Now I know how. I credit the COPD clinic,” says Gayle.

For more information, call Rouge Valley’s Living Well program at 905-683-2320 ext. 1182 or go to www.rougevalley.ca/livingwell.

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