Effectiveness of multi-disciplinary community respiratory team management of chronic respiratory illness during the COVID-19 pandemic

Abstract

<b>Introduction:</b> The Community Respiratory Response Team (CRRT) was established to manage patients in Greater Glasgow &amp; Clyde NHS Trust with chronic lung disease at home during the COVID-19 pandemic. <b>Methods:</b> The relationship between CRRT input and emergency department (ED) attendance, hospital admission and death within 28 days of referral was assessed by primary respiratory condition. <b>Results:</b> Figure 1 shows patient outcomes by primary respiratory condition. Mean patient age was 69 years (median 71; IQR 62-79); COPD 71 years; asthma 51 years. 86% of consultations were conducted remotely; mean 4.4 consultations/patient; 35% had a home visit. No nosocomial COVID-19 infections occurred. 52% of deaths occurred in patients with COPD or asthma/COPD overlap. Increasing number of consultations was associated with reduced mortality but not reduced ED attendance or admissions. However, for patients with COPD triaged as highest risk, having over 3 consultations was associated with lower ED attendance (16% vs 30%) and admission rates (18% vs 26%). Hospital admissions and inpatient deaths for COPD patients in the 2nd quarter of 2020 were 47% and 65% of previous years, respectively. <b>Conclusions:</b> CRRT management was safe and effective in reducing rates of ED attendance, admission and death among patients with COPD and other chronic respiratory disease. Figure 1: CRRT referral pathway and outcomes