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Refer to Patient Preference and Satisfaction in Hospital-at-home COPD Exacerbations and

Usual Hospital Care COPD Exacerbations.

Background: Patient preference plays an important role in the absence of clear differences in
effectiveness and cost-effectiveness between hospital-at-home schemes and usual hospital care.
This study investigates patient preference for treatment place, associated factors, and patient
satisfaction with a community-based hospital-at-home scheme for COPD exacerbations.

Methods: The study is part of a larger randomized controlled trial. Patients were randomized to
usual hospital care or early assisted discharge which incorporated discharge on day four and visits by
a home care nurse until day 7 of treatment (T + 4 days). The hospital care group received care as
usual and was discharged from the hospital on day 7. Patients were followed for 90 days (T + 90
days). Patient preference for treatment place and patient satisfaction (overall and per item) were
assessed quantitatively and qualitatively using questionnaires at T + 4 days and T + 90 days. Factors
associated with patient preference were analyzed in the early assisted discharge group.

Results: 139 patients were randomized. No difference was found in overall satisfaction. At T + 4 days,
patients in the early assisted discharge group were less satisfied with the care at night and were less
able to resume normal daily activities. At T + 90 days, there were no differences for the separate
items. Patient preference for home treatment at T + 4 days was 42% in the hospital care group and
86% in the early assisted discharge group and 35% and 59% at T + 90 days. Patients’ mental state
was associated with preference. Conclusion: Results support the broader implementation of early
assisted discharge for COPD exacerbations, and this treatment option should be offered to selected
patients that prefer home treatment.
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Reference

Maniaci, M. J., Torres-Guzman, R. A., Garcia, J. P., Avila, F. R., Maita, K. C., Forte, A. J., &

Paulson, M. R. (2022). Overall patient experience with a virtual mixed hospital at home

program. SAGE Open Medicine, 10, 205031212210925.

https://doi.org/10.1177/20503121221092589

(Maniaci et al., 2022, p.12)

Phanareth, K., Dam, A. L., Hansen, M. A. B. C., Lindskrog, S., Vingtoft, S., & Kayser, L.

(2021). Revealing the Nature of Chronic Obstructive Pulmonary Disease Using Self-

tracking and Analysis of Contact Patterns: Longitudinal Study. Journal of Medical

Internet Research, 23(10), e22567. https://doi.org/10.2196/22567

(Phanareth et al., 2021, p. 23)