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Evidence summaries

Hospital at Home for Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Treatment of acute exacerbations of COPD in hospital at home with support from respiratory nurses appears to lead to fewer readmissions in comparison with conventional hospital treatment.Level of evidence: "B"

A Cochrane review (abstract , review [Abstract]) included 8 studies with a total of 870 patients. There was a significant reduction in readmission rates for hospital at home compared with hospital inpatient care of acute exacerbations of COPD (RR 0.76, 95% CI 0.59 to 0.99). Moreover, a trend towards lower mortality in the hospital at home group was observed, but the pooled effect estimate did not reach statistical significance (RR 0.65, 95% CI 0.40 to 1.04). For health-related quality of life, lung function (FEV1) and direct costs, the quality of the available evidence was in general too weak to make firm conclusions.

Comment: The quality of evidence is downgraded by imprecise results (wide confidence intervals).

    References

    • Jeppesen E, Brurberg KG, Vist GE et al. Hospital at home for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2012;(5):CD003573. [PubMed]

Primary/Secondary Keywords