Department of Health Policy and Management, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si 24341, Republic of Korea.
Department of Internal Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si 24341, Republic of Korea.
Int J Environ Res Public Health. 2023 Aug 2;20(15):6507. doi: 10.3390/ijerph20156507.
Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition characterized by persistent inflammation in the airways, resulting in narrowing and obstruction of the air passages. The development of COPD is primarily attributed to long-term exposure to irritants, such as cigarette smoke and environmental pollutants. Among individuals hospitalized for exacerbations of COPD, approximately one in five is readmitted within 30 days of discharge or encounters immediate post-discharge complications, highlighting a lack of adequate preparedness for self-management. To address this inadequate preparedness, transitional care services (TCS) have emerged as a promising approach. Therefore, this study primarily aims to present a detailed protocol for a multi-site, single-blind, randomized, controlled trial (RCT) aimed at enhancing self-management competency and overall quality of life for patients with COPD through the provision of TCS, facilitated by a proficient Clinical Research Coordinator. The RCT intervention commenced in September 2022 and is set to conclude in December 2024, with a total of 362 COPD patients anticipated to be enrolled in the study. The intervention program encompasses various components, including an initial assessment during hospitalization, comprehensive self-management education, facilitation of social welfare connections, post-discharge home visits, and regular telephone monitoring. Furthermore, follow-up evaluations are conducted at both one month and three months after discharge to assess the effectiveness of the intervention in terms of preventing re-hospitalization, reducing acute exacerbations, and enhancing disease awareness among participants. The results of this study are expected to provide a basis for the development of TCS fee payment policies for future health insurance.
慢性阻塞性肺疾病（COPD）是一种渐进性呼吸系统疾病，其特征是气道持续炎症，导致气道变窄和阻塞。COPD 的发展主要归因于长期暴露于刺激物，如香烟烟雾和环境污染物。在因 COPD 加重而住院的患者中，约有五分之一的患者在出院后 30 天内再次入院或出现立即出院后并发症，这表明他们对自我管理的准备不足。为了解决这一不足，过渡护理服务（TCS）应运而生。因此，本研究主要旨在提出一项详细的多地点、单盲、随机对照试验（RCT）方案，通过提供 TCS，由熟练的临床研究协调员来增强 COPD 患者的自我管理能力和整体生活质量。RCT 干预于 2022 年 9 月开始，预计于 2024 年 12 月结束，预计将有 362 名 COPD 患者参与该研究。干预计划包括多个组成部分，包括住院期间的初步评估、全面的自我管理教育、促进社会福利联系、出院后家访和定期电话监测。此外，在出院后一个月和三个月进行随访评估，以评估干预在预防再住院、减少急性加重和提高参与者对疾病的认识方面的效果。预计本研究结果将为未来健康保险制定 TCS 收费政策提供依据。
