title: Effectiveness of a simple intervention on management of acute exacerbations of chronic obstructive pulmonary disease and its cardiovascular comorbidities: COREPOC study.
abstract: OBJECTIVE
  To determine the effectiveness of a simple educational intervention to improve the management of cardiovascular comorbidities in patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  Multicenter study participated in by 26 hospital centers. A panel of experts elaborated a set of recommendations about diagnostic and therapeutic management of acute exacerbation of COPD and cardiovascular comorbidities (coronary artery disease, atrial fibrillation, heart failure and diabetes). The recommendations were graduated as indispensable, advisable and outstanding. Compliance with recommendations were assessed in the discharge letter for COPD patients hospitalized with acute exacerbation in Internal Medicine departments. The protocols to treat the comorbidities in COPD were explained in a clinical session. After 6 months' compliance with recommendations they were reassessed.
  
  
  RESULTS
  A total of 390 cases before and after the intervention were assessed. There was significant progress in 53% of cases. The improvement was greater in cases referred to general management and COPD management (66.7 and 76.9%, respectively), and lower in cases referred to ischemic heart disease (11.1%) and none in those referred to coronary artery disease. After the intervention, the adherence to overall and indispensable recommendations was higher (P=.020 and P=.017, respectively) and a trend to improve was observed in advisable (P=.058) and outstanding recommendations (P=.063).
  
  
  CONCLUSIONS
  A simple intervention can improve the management of lung disease in COPD patients with an acute exacerbation, but has less effect on the management of comorbidities.
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, España; Grupo de investigación en Comorbilidad y Pluripatología en Aragón, Instituto Aragonés de Ciencias de la Salud, Zaragoza, España; Departamento de Medicina, Dermatología y Psiquiatría, Universidad de Zaragoza, Zaragoza, España. Electronic address: jdiez@aragon.es.
authors.forename: Jesús
authors.initials: J
authors.lastname: Díez-Manglano
authors.affiliation: Servicio de Medicina Interna, Hospital Vall d'Hebron, Barcelona, España; Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: Jesús
authors.initials: J
authors.lastname: Recio Iglesias
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Virgen del Rocío, Sevilla, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Biomedicina de Sevilla, Sevilla, España.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Varela Aguilar
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Mutua de Terrassa, Terrassa, Barcelona, España.
authors.forename: Pere
authors.initials: P
authors.lastname: Almagro Mena
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Zubillaga Garmendia
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D002985:Clinical Protocols; D015897:Comorbidity; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000628:therapy*; D013030:Spain / Q000453:epidemiology
keywords: Atrial fibrillation; Chronic obstructive pulmonary disease; Clinical trial; Diabetes; Enfermedad pulmonar obstructiva crónica; Ensayo clínico; Fibrilación auricular; Heart failure; Insuficiencia cardiaca; Isquemia miocárdica; Myocardial ischemia