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December 11, 2018

Intensive Intervention to Improve Outcomes for Patients With COPD

Author Affiliations
  • 1Center for Healthcare Organization & Implementation Research, Veterans Affairs, Bedford, Massachusetts
  • 2The Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts
  • 3Institute for Healthcare Delivery and Population Science, Department of Medicine, University of Massachusetts Medical School–Baystate, Springfield
  • 4Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester
  • 5Center of Innovation for Veteran-Centered & Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington
  • 6Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle
JAMA. 2018;320(22):2322-2324. doi:10.1001/jama.2018.17508

Chronic obstructive pulmonary disease (COPD) is one of the most common chronic conditions contributing to morbidity and mortality. In 2016, it was the third leading cause of years of life lost and diasbility-adjusted life-years in the United States, with an estimated 164 000 deaths.1 Even with aggressive inpatient management, patients who are hospitalized for COPD often experience a recurrent cycle of rehospitalizations, resulting in reductions in overall health and quality of life (QOL).2 To help interrupt this cycle, the Centers for Medicare & Medicaid Services incorporated COPD into the Hospital Readmission Reduction Program, which financially penalizes hospitals with high risk-adjusted readmissions.3 The ensuing interest in COPD readmissions has generated numerous clinical trials that have examined different readmission reduction strategies, although this research has often produced conflicting results, and many studies have failed to demonstrate benefit of transitional care or chronic disease self-management programs.4 Clinicians and health systems are left with limited guidance for how to manage this common disease.