Abstract
BackgroundExacerbations of Chronic Obstructive Pulmonary Disease (COPD) are the main cause for hospitalisation. These hospitalisations result in a high pressure on hospital beds and high health care costs. Because of the increasing prevalence of COPD this will only become worse. Hospital at home is one of the alternatives that has been proved to be a safe alternative for hospitalisation in COPD. Most schemes are early assisted discharge schemes with specialised respiratory nurses providing care at home. Whether this type of service is cost-effective depends on the setting in which it is delivered and the way in which it is organised.Methods/DesignGO AHEAD (Assessment Of Going Home under Early Assisted Discharge) is a 3-months, randomised controlled, multi-centre clinical trial. Patients admitted to hospital for a COPD exacerbation are either discharged on the fourth day of admission and further treated at home, or receive usual inpatient hospital care. Home treatment is supervised by general nurses. Primary outcome is the effectiveness and cost effectiveness of an early assisted discharge intervention in comparison with usual inpatient hospital care for patients hospitalised with a COPD exacerbation. Secondary outcomes include effects on quality of life, primary informal caregiver burden and patient and primary caregiver satisfaction. Additionally, a discrete choice experiment is performed to provide insight in patient and informal caregiver preferences for different treatment characteristics. Measurements are performed on the first day of admission and 3 days, 7 days, 1 month and 3 months thereafter. Ethical approval has been obtained and the study has been registered.DiscussionThis article describes the study protocol of the GO AHEAD study. Early assisted discharge could be an effective and cost-effective method to reduce length of hospital stay in the Netherlands which is beneficial for patients and society. If effectiveness and cost-effectiveness can be proven, implementation in the Dutch health care system should be considered.Trial registrationNetherlands Trial Register NTR1129.
Highlights
Exacerbations of Chronic Obstructive Pulmonary Disease (COPD) are the main cause for hospitalisation
Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease that is currently ranked as fourth major cause of death globally [1]
We presented the protocol of the GO AHEAD study, which assesses the effectiveness and cost-effectiveness of an early assisted discharge intervention for patients admitted to the hospital for a COPD exacerbation
Summary
We presented the protocol of the GO AHEAD study, which assesses the effectiveness and cost-effectiveness of an early assisted discharge intervention for patients admitted to the hospital for a COPD exacerbation. Compared to commonly applied measures of satisfaction, a DCE quantifies the relative importance of the characteristics and levels It assesses the trade-offs that respondents make and provides an estimate of the overall value of early assisted discharge treatments and the usual inpatient hospital care option. Because common satisfaction questionnaires do not quantify the relative importance of attributes and levels, it is likely that patient preferences are not represented correctly in organising the process of care delivery This may lead to suboptimal decision-making and may impair the acceptance of early assisted discharge.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
