COPD accounts for one in eight hospital admissions, 1 million bed days and costs £870–930 m a year.1 Early treatment of exacerbations with steroids reduces severity and may reduce the need for hospital admission.2 We evaluated the acceptance and use of a rescue pack provided on discharge from hospital.Methods
38 patients, discharged between 1 February and 30 June 2011, were supplied a 7 day rescue pack comprising Prednisolone 25 mg and Doxycycline 100 mg (total cost of £7) with education and a self-management plan.Methods
A telephone questionnaire was conducted in July:Results
25 out of 38 (66%) patients were contactable. 11 (44%) were male and 14 (56%) female. The median age was 77 (range 53–89) years. The median time from discharge to telephone contact was 110 (range 21–168) days. 24 (96%) patients acknowledged receipt of the rescue pack. 14 out of 15 (93%) patients who had experienced an exacerbation of COPD had used the rescue pack. Of these 14 patients, 13 (93%) were confident of the benefit and 10 (71%) had obtained a replacement pack. Six of the 38 (16%) patients supplied with a rescue pack were re-admitted with an exacerbation.Conclusions
The results of this service evaluation suggest a cost-effective initiative that may reduce hospital re-admission by promoting earlier treatment. Rescue packs should be supported by education and a self-management plan.