Background: Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of hospital readmissions in America. Over one-third of patients admitted for COPD exacerbations are readmitted within 90 days, with readmissions costing $15 billion. Medicare instituted financial penalties for excessive readmissions after COPD hospitalizations, incentivizing the creation of readmission prediction tools. Two such tools, the [...]

Background: Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) is the third leading cause of readmissions and is now included in the Medicare Hospital Readmissions Reduction Program (HRRP). Our institution developed an inter-professional program aimed at reducing all-cause 30-day readmissions for patients admitted with AECOPD. Methods: We iteratively developed and piloted our inter-professional COPD HRRP [...]

Background: Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of hospital readmissions in America. Over one-third of patients admitted for COPD exacerbations are readmitted within 90 days, with readmissions costing $15 billion. Medicare instituted financial penalties for excessive readmissions after COPD hospitalizations, incentivizing the creation of readmission prediction tools. Two such tools, the [...]

Background: Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) is the third leading cause of readmissions and is now included in the Medicare Hospital Readmissions Reduction Program (HRRP). Our institution developed an inter-professional program aimed at reducing all-cause 30-day readmissions for patients admitted with AECOPD. Methods: We iteratively developed and piloted our inter-professional COPD HRRP [...]

Background: The Centers for Medicare & Medicaid Services (CMS) started penalizing hospitals with “excess” 30-day readmissions, as determined by observed-to-expected ratio, for patients discharged after treatment for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). An understanding of modifiable determinants of 30-day readmission will likely help in developing interventions to reduce preventable AECOPD readmissions. [...]

Background: Correct inhaler technique for COPD medications is essential to achieving optimum delivery into the lungs. Evidence suggests that poor technique is widespread and linked to poor efficacy and adherence. However, the direct relationship between inhaler technique and health status has not been investigated.  Methods: Data from a 2013 US survey dataset of COPD patients [...]

Background: The 2015 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines recommend the use of systemic corticosteroids in the treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Although prior guidelines did not recommend a dose or route, current guidelines recommend oral (PO) prednisone over intravenous (IV) methylprednisolone for non-ICU AECOPD hospitalizations, given [...]

Background: Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity, mortality, and cost with the greatest proportion incurred treating acute exacerbations of COPD (AECOPD). While guidelines recommend oral steroids for the treatment of AECOPD, parental corticosteroids are still used in the inpatient setting; such use is associated with high costs and adverse effects. The [...]

Background: Revefenacin (REV), a once-daily, long-acting muscarinic antagonist for nebulized inhalation, was recently approved for maintenance treatment of chronic obstructive pulmonary disease (COPD). We present post hoc efficacy and safety data from three phase 3 trials in patients with moderate to very severe COPD by patient subgroup (<65 y, 65–75 y, >75 y). Methods: This [...]

Background: Many patients with chronic obstructive pulmonary disease (COPD) have suboptimal peak inspiratory flow rate (sPIFR) because of lung hyperinflation, hypoxemia, and muscle wasting, preventing effective use of dry powder inhalers commonly used to treat COPD. sPIFR and airflow limitation interaction may be responsible for excess symptoms in patients with COPD. Here we characterize baseline [...]