Patients Should Not Skip Follow-Up Visits with Their Pulmonologist

Patients who skip their follow up appointments with their pulmonologists after being hospitalized with chronic obstructive pulmonary disease (COPD) are three times more likely to be readmitted, according to findings published in Chest.

Researchers from Ben-Gurion University Medical Center retrospectively analyzed all COPD patients treated at a lung institute in an Israeli hospital between January 1, 2004 and December 31, 2010 in order to determine the risk for readmission after COPD patients attended or did not attend follow up appointments with their pulmonologist.

The researchers identified 195 patients who were treated in hospitals after COPD exacerbations and they were also able to construct a database and profile of patients who did not attend the follow up visits. The researchers examined this risk against the likelihood of re hospitalization within 90 days of discharge.

Fewer than half (44.1 percent) of the patients enrolled in the study had follow up appointments within 30 days of hospital discharge, the researchers found. By not attending the follow up visits, those patients were found to have increased distant residence, a higher number of hospitalizations in the previous year, and a lower frequency of follow up visits with pulmonologists in the previous year.

The researchers also highlighted that not attending a follow up visit with a pulmonologist after COPD exacerbation hospitalization was met with an increased risk of readmission within 90 days of hospital discharge.

“The potential impact of this study on reducing the admission rate of patients with common respiratory diseases is high,” lead study author Nimrod Maimon, MD, explained in a press release. “Advising a patient to visit a chest physician after discharge may save the next admission and reduce the morbidity burden of this serious disease.”

Other factors, such as residence and number of hospitalizations in the previous year, were linked to missing follow up appointments with pulmonologists. If patients lived more than 18 miles from the clinic, the researchers found they were less likely to attend the follow up. If patients had a high number of re hospitalization over the past year, they were also less likely to attend follow up visits.

However, factors like written recommendations accompanying discharge letters and pre hospital admission visits by the patient to the pulmonologist boosted the rates of attendance after hospital discharge for the patients.

The statement continued by commenting that COPD exacerbations account for 500,000 hospital admissions and $18 billion in healthcare costs. Additionally, more than half of COPD patients who are hospitalized because of exacerbations will be readmitted at least once during the first year after discharge; 14 percent will be readmitted during the first month after discharge, and 7 percent will be readmitted within the first three months.