title: Feasibility study for early supported discharge in adults with respiratory infection in the UK.
abstract: BACKGROUND
  Many patients with pneumonia and lower respiratory tract infection that could be treated as outpatients according to their clinical severity score, are in fact admitted to hospital. We investigated whether, with medical and social input, these patients could be discharged early and treated at home.
  
  
  OBJECTIVE
  (1) To assess the feasibility of providing an early supported discharge scheme for patients with pneumonia and lower respiratory tract infection (2) To assess the patient acceptability of a study comprising of randomisation to standard hospital care or early supported discharge scheme.
  
  
  METHODS
  
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  Liverpool, UK. Two University Teaching hospitals; one city-centre, 1 suburban in Liverpool, a city with high deprivation scores and unemployment rates.
  
  
  METHODS
  200 patients screened: 14 community-dwelling patients requiring an acute hospital stay for pneumonia or lower respiratory tract infection were recruited.
  
  
  METHODS
  Early supported discharge scheme to provide specialist respiratory care in a patient's own home as a substitute to acute hospital care.
  
  
  METHODS
  Primary - patient acceptability. Secondary - safety/mortality, length of hospital stay, readmission, patient/carer (or next of kin) satisfaction, functional status and symptom improvement.
  
  
  RESULTS
  42 of the 200 patients screened were eligible for early supported discharge; 10 were only identified at the point of discharge, 18 declined participation and 14 were randomised to either early supported discharge or standard hospital care. The total hospital length of hospital stay was 8.33 (1-31) days in standard hospital care and 3.4 (1-7) days in the early supported discharge scheme arm. In the early supported discharge scheme arm patient carers reported higher satisfaction with care and there were less readmissions and hospital-acquired infections.
  
  
  CONCLUSIONS
  A small study in a single city. This was a feasibility study and therefore not intended to compare outcome data.
  
  
  CONCLUSIONS
  An early supported discharge scheme for patients with pneumonia and lower respiratory tract infection was feasible. Larger numbers of patients would be eligible if future work included patients with dementia and those residing in care homes.
  
  
  BACKGROUND
  ISRCTN25542492.
authors.affiliation: Biomedical Research Centre (BRC) in Microbial Diseases, Respiratory Infection Group, Royal Liverpool and Broadgreen University Hospital Trust, Prescot Street, L7 8XP Liverpool, UK. andrea.collins@liverpool.ac.uk.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Collins
authors.forename: Odiri J
authors.initials: OJ
authors.lastname: Eneje
authors.forename: Carole A
authors.initials: CA
authors.lastname: Hancock
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Wootton
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Gordon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000628:therapy*; D006113:United Kingdom