1. TEMPLATE DESIGN © 2008 www.PosterPresentations.com Prevalence of educational qualifications and access to information technologies in patients with acute exacerbation of COPD R. Wijayarathna 1,3, E.Suh 1,2,3, S.Mandal 1,2,3, N.Hart 1,2,3,4 1 Lane Fox Clinical Respiratory Physiology Research Centre, Guy’s & St Thomas’ NHS Foundation Trust, London, UK 2 Division of Asthma, Allergy and Lung Biology, King’s College London, UK, 3 Lane Fox Respiratory Unit, Guy’s & St Thomas’ NHS Foundation Trust, London, UK 4 Guy’s and St Thomas’ NHS Foundation Trust and King’s College London, NIHR Comprehensive Biomedical Research Centre, London, UK Introduction Methods Results Conclusion Socioeconomic factors are known to influence clinical outcome in COPD patients, but few studies have addressed the impact of educational attainment (1,2). Furthermore, while there is increasing interest in the use of telehealth for patients with COPD, there are few data relating to patients’ access to the technologies through which telehealth interventions may be delivered. We therefore aimed to ascertain the prevalence of formal educational qualifications and access to information technologies among patients hospitalised with acute exacerbation of COPD (AECOPD). Clinical and physiological data were prospectively gathered from consecutive patients admitted to a metropolitan teaching hospital with AECOPD between April and December 2013. Patient data were analysed according to the possession of educational qualifications, and access to a personal computer and the internet. These data suggest there may be difficulties in implementing the use of telehealth within this metropolitan COPD population. Only 14% had access to a computer and the internet. Patients with no educational qualifications had worse spirometry at admission, but surprisingly a lower symptom burden. This may be due to the fact that those with educational qualifications may have a greater awareness of the symptoms of an exacerbation, and therefore present to hospital at an earlier stage. While telehealth has great potential to transform the chronic care in COPD, attention needs to be paid to individual patients’ levels of education and familiarity with information technology. 100 patients were admitted with AECOPD (40% female, age 70.5±9.3years). 51% of patients lived alone, 38% were current smokers, with FEV 1 0.70±0.39L at admission, and 13% were on long term oxygen therapy. Median duration of symptoms prior to admission was 4 days (IQR 1 to 14). Hospital admission frequency 2 (IQR 1 to 6) per year. Results Table 1. Characteristics of patients admitted with AECOPD. FEV 1 : forced expiratory volume in 1s, NRS: numerical rating scale; CAT: COPD Assessment Test. *p<0.05 compared with patients with educational qualifications; **p<0.05 compared with patients with access to the internet or personal computer. To determine the proportion of patients with educational qualifications and those who had access to information technology at home, and to establish whether such access was related to clinical outcomes Objective We gratefully acknowledge funding by the European Union as part of the Advanced Care Coordination and Telehealth Deployment Project (ACT) led by Philips, and the Department of Physiotherapy, Guy’s and St. Thomas’ NHS Foundation Trust. Acknowledgements 83% of patients had no educational qualifications (Figure 1, Table 1), while 86% had no access to the internet or a personal computer (Table 1). Women were less likely to have formal educational qualifications. Patients with no educational qualifications had a lower %predicted FEV 1 (31.2±23.6% vs. 38.7±20.9%, p<0.05), and were less likely to have access to information technologies (7% vs. 93%, p<0.05). EducationalAccess to personal qualificationscomputer or Internet Yes (n=17) No (n=83) Yes (n=14) No (n=86) %Male/Female76/24%57/43% 60/40% Age (years) 69.4 (8.3) 70.6 (9.4) 64.8 (7.7) 71.3 (9.2)** FEV 1 %predicted 38.7 (20.9) 31.2 (23.6)* 23.6 (16.2) 34.9 (24.2) 28 day readmission 18%13%016% NRS for dyspnoea (/10) 5.0 (2.0) 3.6 (2.1) 3.8 (1.9) 3.8 (2.1) CAT score (/40)24 (10.8)21.8 (10.8)21 (10)22 (11) Length of hospital stay (days) 4.1 (2.9)6.0 (6.2)5.0 (7.1)5.7 (5.6) Figure 1. Educational qualifications of 100 patients admitted with AECOPD. Patients with no educational qualifications were no more likely to be readmitted within 28 days, and presented with a lower symptom burden on admission as measured by the numerical rating scale for dyspnoea (3.6/10 vs. 5.0/10). Patients with access to the internet or a computer were significantly younger (Table 1) and were less likely to be readmitted within 28 days of discharge from hospital (0% vs. 16%). There was no significant difference in spirometry or symptoms at admission. 1.Eisner MD, Blanc PD, Omachi TA, et al. Socioeconomic status, race and COPD health outcomes. J Epidemiol Community Health 2011;65:26-34. 2.Mannino DM, Buist AS. Global burden of COPD: Risk factors, prevalence, and future trends. The Lancet;370:765- 773. References