• Breda Cushen, Aisling Madden, Deirdre Long, Yvonne Whelan, Michael Emmet O'Brien, Deirdre Carroll, Des O'Flynn, Michelle Forde, Virginia Pye, Loretto Grogan, Margaret Casey, Karolina Farrell, Richard W Costello, and Clare Lewis.
• Department of Respiratory Medicine, Beaumont Hospital, Dublin 9, Dublin, Ireland. bredacushen@beaumont.ie.
• Ir J Med Sci. 2022 Apr 1; 191 (2): 615-621.

BackgroundChronic respiratory diseases are responsible for significant patient morbidity, mortality, and healthcare use. Community virtual ward (CVW) models of care have been successfully implemented to manage patients with complex medical conditions.AimsTo explore the feasibility and clinical outcomes of a CVW model of care in patients with chronic respiratory disease.MethodsPatients known to specialist respiratory services with Chronic Obstructive Pulmonary Disease (COPD) and/or asthma were admitted to the CVW for disease optimisation and exacerbation management. Individualised management plans were delivered in the patients' home by hospital-based respiratory and community nursing teams, incorporating remote technology to monitor vital signs. Symptoms and health status at admission and discharge were compared.ResultsTwenty patients were admitted. One-quarter of patients had asthma, 50% COPD, and 25% combined asthma/COPD. Patients had severe disease, mean (SD) FEV1 50(20) % predicted, and an average 6.4(5.7) exacerbations of disease in the previous 12 months. Patients received personalised disease and self-management education. All acute exacerbations (n = 11) were successfully treated in the community. The average length of CVW admission was 10(4) days. By discharge, 60% of COPD and 66% of asthma patients recorded improvements in symptoms score exceeding the minimal clinically important difference. Fifty percent had clinically meaningful improvements in health status.ConclusionA CVW model facilitates the delivery of combined specialist and generalist care to patients with chronic respiratory disease in the community and improves symptoms and health status. The principles of the model are transferable to other conditions to improve overall health and reduce emergency hospital care.© 2021. Royal Academy of Medicine in Ireland.

13 keywords...

hide…