COPD community

• What is the main focus of the lecture on Community COPD Management?

  Acute management in the community and hospital-at-home services for deteriorating COPD patients
• Why is palliative care important for end-stage COPD patients?

  It addresses the needs of patients who are rapidly deteriorating
• What is a key question to ask when assessing the need for hospital admission for COPD patients?

  Does he really need to be in hospital?
• What are the aims of hospital-at-home/assisted-discharge/early discharge schemes?

  • Reduce hospital length of stay
  • Improve patient education
  • Support self-management
• Who runs the hospital-at-home services?

  A multiprofessional team
• What factors should be considered when selecting patients for hospital-at-home services according to NICE guidelines?

  Resources available, absence of factors associated with worse prognosis, and patient’s preference
• What are the inclusion criteria for early supported discharge for COPD patients?

  • Established diagnosis of COPD
  • No significant infection
  • pH > 7.35
  • pCO₂ < 8.0 kPa on room air
  • paO₂ > 7.5 kPa on room air
  • Patient and carer support
  • Suitable social circumstances
  • Ability to communicate in English
• What are the exclusion criteria for early supported discharge for COPD patients?

  • Impaired level of consciousness
  • Acute confusion
  • Suspected new malignancy
  • Requiring IV medications
  • Significant CXR changes
  • Concomitant medical problems requiring inpatient stay
  • Cardiac chest pain
  • Acute ECG changes
  • Requires IV therapy
  • Suspected pulmonary embolism
  • Cognitive impairment preventing self-care