Chronic Obstructive Pulmonary Disease Theo dõi

Monitoring

Assess Suitability for Discharge

Prior to discharge from the hospital, check if the patient is able to use long-acting either beta₂-agonists and/or anticholinergics with or without ICS and if inhaled beta2-agonist is needed every 4 hours or less frequently.

Also check if the patient is already able to walk across the room (if previously ambulatory), able to eat and sleep without frequent interruptions due to breathing difficulty, is clinically stable for 12-24 hours, and his/her ABG results are stable for 12-24 hours.  

Prior to discharge, make sure that the home care arrangements (eg oxygen delivery) are in place. It is also essential that the patient and caregiver adequately understand the correct medication use, and that the patient, family, and physician are confident that the patient can manage well.  

Arrange for Follow-up Assessments  

A follow-up assessment must be carried out within 4-12 weeks following discharge from the hospital for exacerbations. This is to check the patient’s ability to cope in his environment, measure FEV₁, check inhaler technique, and check understanding and ability to follow the treatment regimen.  

During follow-up, one may also assess the need for long-term oxygen therapy and/or home nebulizer for patients with very severe COPD.  

It is also important to check for the status of comorbidities (eg cardiovascular diseases, lung cancer, osteoporosis, depression or anxiety, diabetes mellitus, metabolic syndrome, GERD, obstructive sleep apnea, bronchiectasis, infections).  

Remote consultations or follow-ups may be considered during the COVID-19 pandemic if the patient is able to understand the process and can provide clear information, there is a regular follow-up, the medical records and laboratory tests are accessible to the healthcare provider, and that access to medication is possible.