A National Partnership with the COPD Foundation to Implement the COPD Virtual Medication Reconciliation and Education: COPD V-M(ED) Pilot

ABSTRACT

Rationale COPD is the fourth leading cause of US hospitalizations. The majority of hospitalized patients misuse inhalers, a factor unrecognized by many patients and clinicians. COVID-related distancing requirements and decreased in-person care has further challenged the quality and modality of care-delivery, including opportunities for inhaler education. There is a critical need for innovation to deliver this critical aspect of COPD care. This study aims to improve clinician-patient communication and access to care for patients with COPD by developing and implementing a telehealth education platform to augment the clinic visit. Methods: This mixed-methods study utilized semi-structured patient interviews and clinician survey data to obtain diverse perspectives about facilitators and barriers to our “V-M(ED)” intervention. Patients participated in the COPD V-M(ED), pharmacy-led video visits with patients to conduct inhaler technique education using teach-to-goal, during clinic visits. Eligible patients were consented to participate in semi-structured interviews assessing their experiences with prior telehealth visits, inhaler education, and feedback on V-M(ED). Clinicians recruited via email completed brief surveys focusing on barriers, facilitators, and opportunities for incorporating multi-disciplinary teams to deliver telehealth-based educational teaching for patients. Demographic and Likert-scale data were analyzed with descriptive statistics. Themes were coded for open-ended questions. Results: Of 15 clinic patients who received inhaler education, 10 were enrolled in the study. Participants were on average 73.7 years of age, 80% were female, and 90% self-identified as Black. Three major themes emerged regarding patient telehealth experience (Table) 1) the pros and cons of technology-based visits (e.g., convenience);2) setting preference for clinical visits (e.g., in-person);and 3) effectiveness of virtual inhaler education (e.g., most reported benefiting). Thirteen clinicians completed the care team perspectives survey. While the majority felt incorporating virtual teaching from clinician team-members would be beneficial to patients, only 31% reported that the benefits would outweigh barriers to use. However, of clinicians who did not have prior experience incorporating virtual education into patient encounters, nearly half reported they would use a program if it were in place. Conclusions: This study provides important insights into both patient and clinician perspectives on integrating virtual telehealth education into patient care. Despite a preference for in-person clinical encounters, using a telehealth modality for inhaler education was well-received by our patient cohort. This feedback, along with the positive attitudes of clinicians in the usefulness and desire to offer virtual video platforms for patient education, suggests virtual education can be an effective modality for disease self-management. (Table Presented).