Clinical Outcomes of Multidisciplinary Care in Chronic Obstructive Pulmonary Disease Patients at the Central Chest Institute of Thailand
Kanlaya Panjapornpon MD*, Sonklin Tanont BNS**
Affiliation : * Department of Pulmonary Medicine, Central Chest Institute of Thailand, Nonthaburi, Thailand ** Department of Outpatient Nursing, Central Chest Institute of Thailand, Nonthaburi, Thailand
Objective : To compare clinical outcomes before and after are enrolled study within 1 year and factors related to Chronic
Obstructive Pulmonary Disease (COPD) exacerbations after enrolled.
Material and Method: COPD patients who were compatible with inclusion criteria in COPD clinic at the Central Chest
Institute of Thailand between March 2007 and July 2010. Baseline characteristics, COPD management program, bronchodilator
used, and clinical outcomes were recorded by a search of retrospective databases, as well as the patient medical records.
Results : A total of 247 enrolled patients compatible with inclusion criteria were analyzed. Most of the patients were male, 240
patients (97.2%). The average age of the patients was 69.3 + 9.1 years. The majority of patients were in GOLD stage II, 121
patients (49.0%). After multidisciplinary care was performed. In an overall 219 patients (88.6%) of COPD patients received
appropriate bronchodilator treatment classified by GOLD stage which had different proportions in each stage significantly
[stage I = 45 patients (100%), stage II = 103 patients (86.6%), stage III = 58 patients (86.6%), stage IV = 13 patients
(92.8%), p = 0.026]. COPD exacerbations frequency (0.9 + 1.6 vs. 0.3 + 0.9, p < 0.001), COPD related-hospitalizations (0.2
+ 0.8 vs. 0.1 + 0.4, p < 0.001), COPD related-respiratory failure (0.04 + 0.25 vs. 0.008 + 0.090, p = 0.020) were
significantly decreased after enrolled. On multivariate analysis, COPD patients who had exacerbations frequency more than
one time per year were prone to have repeated COPD exacerbations approximately three times more than other COPD
patients (Adjusted Odds ratio 2.80, 95% CI, 1.08 to 7.26, p = 0.034).
Conclusion : Multidisciplinary care in COPD patients can significantly improve clinical outcomes.
Keywords : Multidisciplinary care, COPD, Clinical outcomes, Exacerbations
