An exciting new pilot in the North West of Glasgow has shown promising results in helping people who have Chronic Obstructive Pulmonary Disease (COPD) manage their condition and prevent them from having to be admitted to hospital.
More than 40 per cent of people with COPD in the Glasgow and Clyde area live in the North West of Glasgow. COPD is a progressive disease which makes breathing difficult and can mean that people have to be admitted to hospital if symptoms worsen.
During 2013/14 more than 300 people with COPD took part in a pilot run by Glasgow City Community Health Partnership. The pilot, which is one of a number to be funded by the Reshaping Care for Older People, offered a number of ways for people to live and even improve their condition.
The North West CHP Community Respiratory Team was set up to help patients manage their condition and ultimately try to prevent them from having to be admitted into hospital. The team work closely with specialist respiratory nurses, consultant physicians, community nurses and GPs and is made up of health care professionals from Physiotherapy, Occupational Therapy, Pharmacy and Rehabilitation Support. They work closely together and visit patients in their own home to provide:
• Support to prevent unnecessary and unscheduled hospital admissions of COPD patients by the treatment of exacerbations, disease management, and improved education.
• Support for the patient to allow early discharge from hospital, working closely with the Early Supported Discharge team.
• Home based personalised pulmonary rehabilitation for housebound patients and provision of equipment to help people stay independent.
• Advice for patients on self management strategies (including inhaler technique).
• Comprehensive medication review for patients with COPD.
• Regular home contact by the team to supply advice, reassurance and guidance in self care.
• Ways of identifying and monitoring patients at high risk of exacerbations and undertake activities to avoid emergency admissions.
• Direct access for patients to the team to optimise self management and early response to treatment.
Since the pilot began evaluation has shown that 94 per cent of those who were at risk of being admitted to hospital were seen by the team within one day.
Two weeks following an assessment 80 per cent of patients avoided being admitted to hospital.
Clinical outcome measures are demonstrating significant improvements in patients’ ability to cope with their symptoms and improve their quality of life.
Dr Anne Scoular, Consultant in Public Medicine who has supported evaluation of the pilot, said: “We are delighted with the emerging results from this project. We know that the number of people who develop COPD is set to increase by 33 per cent in Scotland over the next 20 years, so it’s important that we find ways of tackling this disease and to avoid having to admit people into hospital when this is not always the best option.
“COPD is a very debilitating progressive disease which can have a major impact on a person’s life in its latest stages. However, we know that if we work with patients, help them understand and monitor their condition and encourage more patients to access pulmonary rehabilitation, then we can make a real difference to people’s lives and allow them to successfully manage their condition in their own homes.
“The pilot is funded until the end of December 2014 when the final results of the evaluation will be shared throughout NHS Greater Glasgow and Clyde.”
Patients who have been part of this project have said:
“Everything possible to be honest with you, they saved me going to the hospital. They showed me my medication I had been taking I was taking wrong. They fixed all that out. I wouldn't have known what to do without the staff. The physiotherapist arranged for me to get a delta and went over my nebulisers. The occupational therapist arranged for a bath thing for my daughter to help me get a bath.”
"I did discover how important it is to keep my wits about me with my breathing and stay calm. I could be at absolute panic stations before so the physio was really good at getting it into my head that I need to control this. I can't just turn up at hospital every time. She was essential at getting my confidence up but it's not only that I could control it but that I could have gone on floundering “
"The staff were nice really helpful, they said you make a goal. I aimed for 6 weeks and I did it in 3. I wasn't in control of it before and now I'm good. I'm not so hemmed in with it. I've got a bit of my life back. I can get out even without my inhaler always on the go now"
Notes to editors
In Scotland there are approximately 100,000 people living with Chronic Obstructive Pulmonary Disease (COPD) with a predictive increase of 33% in the next 20 years (NHSQIS, 2010).
The prevalence of COPD in the Greater Glasgow and Clyde population is 2.28% and the number of hospital admissions is the highest in Scotland at 10,039 (ScotPHO, 2010) with 19% admitted twice during the year and 16% admitted three or more times (Audit Scotland).
For further information either telephone 0141 201 4429 or email [email protected]
Follow us on Twitter @nhsggc