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Treating Pneumonia In The Home. Does It Work?

Treating Pneumonia In The Home. Does It Work?

Christchurch School of Medicine and Health Sciences, Otago University and the Pegasus Health IPA together with the Canterbury District Health Board have embarked on a landmark New Zealand study to evaluate the treatment of milder forms of pneumonia in the home rather than in hospital.

Since 2000 Christchurch2000 Christchurch based IPA Pegasus Health, using its innovative Extended Care Programme, has been providing home treatment of some conditions traditionally treated in hospital. The success of this innovative approach is now being evaluated in a randomised controlled trial funded by Pegasus Health and carried out by the School of Medicine and Health Sciences.

“What this project aims to do is to clarify the effectiveness, safety and comparative cost of treating patients with milder community acquired pneumonia in the home rather than admitting them to hospital,” explains Dr Derelie Richards from the School of Medicine’s Department of General Practice.

Pneumonia is an illness that traditionally has been treated in hospitals. More recently health professionals believe that the necessary treatment can be provided just as successfully in the home, so long as there is adequate community care available from GPs and experienced nurses and good links with hospital specialists.

The study team has begun recruiting patients who present at hospital with mild pneumonia and offered them the opportunity to be randomised to either home or hospital treatment. These two groups with similar mild pneumonia will be compared for clinical outcome, patient satisfaction and cost. In total the study will gather information on 200 patients, half cared for at home and half in a hospital setting as usual.

"People receiving home care will be very well looked after,” says Dr Richards. “The Pegasus Health Extended Care team of GPs and experienced nurses will set up intravenous anti-biotic treatment when patients first go home. All patients will be visited regularly each day by the Extended Care team of doctors and nurses. Emergency contacts will also be available.

Dr Richards says a patient’s own GP will also visit, taking over the care when a patient is discharged from the Extended Care team.

“Essentially patients will be getting the same treatment as in hospital, except they will be at home and in a familiar environment,” she says. There will be full follow up care and questionnaires two and six weeks after treatment has finished.

Dr Graham McGeoch, a G.P and Director of Pegasus Health, agrees. “Our experience shows that patients respond well to being cared for in the environment that they are most comfortable with, in most cases this is at home. Pegasus Health has long believed that this approach is the way of the future, and this is why we developed the Extended Care programme initially.

Professor Ian Town, Dean of the School of Medicine, is part of the study team. “We’re delighted to be involved with this project which involves colleagues from both general and respiratory medicine along with the Emergency Department and Canterbury Health Laboratories. We’ve had a longstanding research interest in pneumonia and this study is looking at new ways of working collaboratively”

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