MedWire News: Patients with chronic obstructive pulmonary disease may benefit from access to a 24-hour, nurse-led 'hotline' to reduce their risk of needing hospital treatment for sudden breathing difficulties, called exacerbations, Australian researchers have found.

"Despite recent advances in the management of patients with chronic obstructive pulmonary disease, interventions to reduce hospitalisation have had only modest success," explain Dr Tracey Robinson, from the Westmead Hospital in New South Wales, and colleagues.

The team therefore assessed the ability of a 24-hour, 7-days a week, nurse-led telephone line set up by The Respiratory Ambulatory Care Service in Western Sydney in September 2002 to offer support to patients with chronic obstructive pulmonary disease. The hotline placed particular emphasis on the prevention and early treatment of exacerbations.

A total of 458 patients with the lung disease were given access to the hotline between Sptember 2002 and November 2004.

Over the study period, 675 calls were made to the hotline by 118 patients, with more than half of all calls made after normal surgery hours.

The researchers found that advice given by the hotline staff averted calls to the emergency services in 12% of cases. Specific advice about the treatment of exacerbations was given to a further 17% of callers.

Callers tended to have worse lung function, lower exercise capacity and used home oxygen kits more often than those who did not use the hotline.

"The results suggest that patients with severe chronic obstructive pulmonary disease, even when optimally managed, benefit from additional expert help with self-management," Dr Robinson and team write in the Internal Medicine Journal.

They conclude: "This report shows that a nurse-led, 24-hour hotline for patients with chronic obstructive pulmonary disease is safe, is used by patients and carers and, when used, potentially reduces hospital presentations even in a group of patients with severe disease."