Variations in Practice Patterns Seen in Patients Treated for COPD
THURSDAY, July 19, 2018 -- There are significant variations in practice patterns and resource utilization in patients treated by teaching staff for acute exacerbations of chronic obstructive pulmonary disease (AECOPD), compared to non-teaching staff, according to a study published in the June issue of the Journal of Evaluation in Clinical Practice.
Sunil H. Adwani, M.D., from the Florida Hospital in Orlando, and colleagues retrospectively evaluated data from 354 patients admitted to a community hospital with AECOPD (January 2009 through December 2011) in order to assess differences in practice patterns between teaching and non-teaching services and their effect on length of stay (LOS).
The researchers found that LOS was significantly lower in the teaching group compared with the non-teaching group (2.80 versus 5.04 days). Additionally, in the teaching group there was significantly greater use of oral steroids (85 versus 8.9 percent), greater use of oral antibiotics (72 versus 33 percent), and lower utilization of consults (0.3 versus 1.4 consults per patient), compared with the non-teaching group. After adjustment for difference in practice patterns, the teaching service no longer had a decreased LOS. Increased use of consults was independently associated with increased LOS.
"The study identifies an opportunity for more efficient and cost-effective care of AECOPD patients through streamlining of consultations, use of oral steroids in lieu of intravenous steroids, and antibiotic stewardship," the authors write.
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Posted: July 2018