Outcome evaluation of care Among Patients with Chronic Obstructive Pulmonary Disease in Luangphorpern Hospital under the coronavirus disease 2019 (COVID-19) pandemic

Abstract

        This research and development study aimed to 1) evaluated the outcomes of care among patients with Chronic Obstructive Pulmonary Disease. (COPD) during the pandemic of the Coronovirus Disease 2019 (COVID-19) situation 2) compared the outcomes of care among the COPD patients before and during the COVID-19 pandemic situation 3) investigated the problems and developed the guidelines management for COPD patients in the COVID-19 pandemic situation 4) evaluated the outcome after implementing the guideline. The eligible participants was 47 COPD patients by purposive selecting, non-randomization and the 8 of multidisciplinary team who were specifically selectived. The research instruments including the Personal Data questionnaire, the data record form of COPD patients, the interview questions guideline and group meetings. Collecting Data, the data collection was from the outpatient medical records. The interviwing was coducted as informal interviews and group meetings. Analyzing data by used the descriptive statistics, content analysis, and the Paired t-test statistic.

         Results: An evaluation of the process of care among COPD patients during the COVID-19 pandemic revealed that during the pandemic situation the COPD patients had significntly acute exacerbations requiring emergency room treatment (ER visits) higher than before the COVID-19 outbreak (p<.05). As a result, the COPD patients required more hospitalization due to exacerbation than before the COVID-19 outbreak, but not statistically significant (p>.05). With social distancing protocol affected problems in process of care among COPD patients during the COVID-19 pandemic, it caused the patients home isolation, the COPD patients have lost follow-up and necessary activities of care for supporting from the multidisciplinary team such as the medication adherence, the pulmonary function testing by blowing the Peak Flow Meter, teaching/evaluating the use of inhalers, Smoking Cessation clinic and Pulmonary Rehabilitation clinic by the physical therapists. Researchers and multidisciplinary teams work together to developed the guidelines management for COPD patients in the COVID-19 pandemic situation by opening the COPD Clinic service, appropriately established and developed about the guideline management of pre-services, during and post-services. Adding the number of the registered nurses (RN) at the screening / triage process for discriminated the critically ill patients, the patients with respiratory problem, and emergency patients to deliver appropriate and safe managments. Emphasized an individual education and personal counseling on how to behave properly. Physicians, pharmacists and physical therapists followed the guidelines managment for COPD patients with strict measures to prevent the spread of COVID-19. After implementation found that the COPD patients had a statistically significant lower in mean of ER visits, admissions, and costs than before implementing the guideline management of the COPD patients (p<.05), indicated that the guideline was practical and feasibility with favorable outcomes among the COPD patients. The COPD patients had access to quality COPD Clinic services, reducing risk and aggressive symptoms of COPD, and reduce the cost of medical care. Conclusion: this research suggested that this guidelines management for COPD patients in the COVID-19 pandemic situation should be implemented and evaluated ongoing .