Effects of a Comprehensive Care Program on the Readmission Rate and Adherence to Treatment in Elderly Patients with Chronic Obstructive Pulmonary Disease

Document Type : Original Article


1 School of Nursing and Midwifery, Student Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Iran

2 Department of Medical Surgical Nursing, School of Nursing and Midwifery, Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran

3 Department of Internal Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.


Background: The low treatment adherence of patients with chronic obstructive pulmonary disease (COPD) leads to the exacerbation of their symptoms and readmission. Comprehensive care programs are among interventions that can improve the patients’ adherence to treatment and prevent readmission. The present study aimed to evaluate the effects of a comprehensive care program on the adherence to treatment and readmission of COPD patients.
Materials and Methods: This randomized clinical trial was performed in a hospital in Rafsanjan, Iran, in 2017. Sixty elderly patients with COPD were randomly enrolled in this study by pair-matching. The intervention group participated in a comprehensive care program, whereas the control group received routine care. The readmission rate and adherence to treatment were measured at one-, three-, and six-month intervals. To evaluate the patients’ adherence to treatment, an adherence-to-treatment questionnaire for chronic diseases was used. Data were analyzed using Chi-square test, independent t-test, and repeated measures ANOVA at a significance level of 0.05.
Results: A significant difference was observed between the two groups in terms of readmission at the end of the study (P=0.03). In the intervention group, the mean level of adherence to treatment and its subscales improved as compared to the control group, and there was a significant difference between the two groups.
Conclusion: Although most of the patients in this study were old, with a rather low educational level and socioeconomic status, the care program could improve their treatment adherence and reduce the readmission rate.