{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T15:58:19Z","timestamp":1784649499745,"version":"3.55.0"},"reference-count":55,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,4]],"date-time":"2026-01-04T00:00:00Z","timestamp":1767484800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AstraZeneca"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ARM"],"abstract":"<jats:p>Introduction: This document presents recommendations of the Polish Respiratory Society on discharge instructions following hospitalization for an exacerbation of chronic obstructive pulmonary disease (COPD). Methods: The Delphi method was applied to achieve consensus among independent experts. Results: Fourteen recommendations were formulated. Experts emphasized that discharge summaries require clear graphical and editorial design to ensure readability for both patients and healthcare professionals. The involvement of a multidisciplinary team was recommended to provide coherent and comprehensive documentation. Discharge instructions should be discussed with the patient during hospitalization and supplemented with standardized educational materials provided separately. These materials should cover inhaler technique, smoking cessation, physical activity, pulmonary rehabilitation, and vaccination. For patients with respiratory failure, home oxygen therapy or non-invasive ventilation must be addressed. Discharge recommendations should highlight modifications in baseline COPD treatment and management of comorbidities. A personalized action plan for future exacerbations is essential, and dietary consultation is advised. Finally, discharge summaries should specify follow-up appointments and include prescriptions for inhaled medications. Conclusions: The Polish Respiratory Society recommends that discharge instructions be provided to all patients hospitalized for a COPD exacerbation.<\/jats:p>","DOI":"10.3390\/arm94010004","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T12:38:56Z","timestamp":1767616736000},"page":"4","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Recommendations Following Hospitalization for Acute Exacerbation of COPD\u2014A Consensus Statement of the Polish Respiratory Society"],"prefix":"10.3390","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3501-167X","authenticated-orcid":false,"given":"Adam Jerzy","family":"Bia\u0142as","sequence":"first","affiliation":[{"name":"Department of Pneumology, Medical University of Lodz, 90-153 \u0141\u00f3d\u017a, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6567-9208","authenticated-orcid":false,"given":"Adam","family":"Barczyk","sequence":"additional","affiliation":[{"name":"Department and Clinic of Pneumology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5622-3439","authenticated-orcid":false,"given":"Iwona","family":"Damps-Konsta\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Pneumonology, Medical University of Gda\u0144sk, 80-210 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5181-4360","authenticated-orcid":false,"given":"Aleksander","family":"Kania","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Jagiellonian University Medical College, 30-688 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3205-3647","authenticated-orcid":false,"given":"Krzysztof","family":"Kuziemski","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, School of Public Health, Collegium Medicum, University of Warmia and Mazury, 10-357 Olsztyn, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0881-2884","authenticated-orcid":false,"given":"Justyna","family":"Ledwoch","sequence":"additional","affiliation":[{"name":"Section of Guidelines and Recommendations, Polish Society of Family Medicine, 51-141 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krystyna","family":"Ras\u0142awska","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Diseases and Tuberculosis, Independent Public Healthcare Institution, Saint John Paul II Memorial Specialist Hospital of the Ministry of Interior and Administration, 48-340 G\u0142ucho\u0142azy, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u0142gorzata","family":"Czajkowska-Malinowska","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Diseases and Respiratory Failure with the Subunit of Noninvasive Ventilation and the Subunit of Sleep-Related Breathing Disorders, Kuyavian-Pomeranian Pulmonology Center, 85-326 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,4]]},"reference":[{"key":"ref_1","unstructured":"Global Initiative for Chronic Obstructive Lung Disease (GOLD) (2025, December 10). Global Strategy for the Diagnosis, Management and Prevention of COPD, 2026 Report. Available online: https:\/\/goldcopd.org\/2026-gold-report\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/S2213-2600(24)00339-4","article-title":"The global burden of COPD: Epidemiology and effect of prevention strategies","volume":"13","author":"Celli","year":"2025","journal-title":"Lancet Respir. Med."},{"key":"ref_3","unstructured":"(2024, September 23). Mapy Potrzeb Zdrowotnych\u2014Baza Analiz Systemowych i Wdro\u017ceniowych, Available online: https:\/\/basiw.mz.gov.pl\/analizy\/problemy-zdrowotne\/przewlekla-obturacyjna-choroba-pluc\/."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1056\/NEJMra1900500","article-title":"Update on Clinical Aspects of Chronic Obstructive Pulmonary Disease","volume":"381","author":"Celli","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1016\/S2213-2600(23)00261-8","article-title":"COPD and multimorbidity: Recognising and addressing a syndemic occurrence","volume":"11","author":"Fabbri","year":"2023","journal-title":"Lancet Respir. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1183\/09031936.00128008","article-title":"Systemic manifestations and comorbidities of COPD","volume":"33","author":"Barnes","year":"2009","journal-title":"Eur. Respir. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"73","DOI":"10.20452\/pamw.1177","article-title":"Health state and the quality of life in patients with chronic obstructive pulmonary disease in Poland: A study using the EuroQoL-5D questionnaire","volume":"122","author":"Boros","year":"2012","journal-title":"Pol. Arch. Med. Wewn."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1164\/rccm.201201-0034OC","article-title":"Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease","volume":"186","author":"Divo","year":"2012","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.2147\/COPD.S82420","article-title":"Underrecognized comorbidities of chronic obstructive pulmonary disease","volume":"10","author":"Piotrowski","year":"2015","journal-title":"Int. J. Chronic Obstr. Pulm. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1183\/09031936.00166108","article-title":"Present and future costs of COPD in Iceland and Norway: Results from the BOLD study","volume":"34","author":"Nielsen","year":"2009","journal-title":"Eur. Respir. J."},{"key":"ref_11","unstructured":"(2018, May 31). Mapy Potrzeb Zdrowotnych: Wnioski i Rekomendacje. Choroby Uk\u0142adu Oddechowego (Przewlek\u0142e), Available online: https:\/\/mpz.mz.gov.pl\/wp-content\/uploads\/sites\/4_old_0212\/2018\/05\/uklad_oddechowy_20180531.pdf."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1007\/s11606-008-0618-9","article-title":"Redefining and redesigning hospital discharge to enhance patient care: A randomized controlled study","volume":"23","author":"Balaban","year":"2008","journal-title":"J. Gen. Intern. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1002\/jhm.228","article-title":"Promoting effective transitions of care at hospital discharge: A review of key issues for hospitalists","volume":"2","author":"Kripalani","year":"2007","journal-title":"J. Hosp. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"121","DOI":"10.7326\/0003-4819-143-2-200507190-00011","article-title":"Patient safety concerns arising from test results that return after hospital discharge","volume":"143","author":"Roy","year":"2005","journal-title":"Ann. Intern. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1111\/1742-6723.12285","article-title":"Review article: Components of a good quality discharge summary: A systematic review","volume":"26","author":"Wimsett","year":"2014","journal-title":"Emerg. Med. Australas."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Weetman, K., Spencer, R., Dale, J., Scott, E., and Schnurr, S. (2021). What makes a \u201csuccessful\u201d or \u201cunsuccessful\u201d discharge letter? Hospital clinician and General Practitioner assessments of the quality of discharge letters. BMC Health Serv. Res., 21.","DOI":"10.1186\/s12913-021-06345-z"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Weetman, K., Dale, J., Scott, E., and Schnurr, S. (2020). Adult patient perspectives on receiving hospital discharge letters: A corpus analysis of patient interviews. BMC Health Serv. Res., 20.","DOI":"10.1186\/s12913-020-05250-1"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1111\/ijcp.12686","article-title":"Communication in healthcare: A narrative review of the literature and practical recommendations","volume":"69","author":"Vermeir","year":"2015","journal-title":"Int. J. Clin. Pract."},{"key":"ref_19","unstructured":"Centers for Disease Control and Prevention (U.S.) (2025, August 20). Simply Put: A Guide for Creating Easy-to-Understand Materials, Available online: https:\/\/stacks.cdc.gov\/view\/cdc\/11938."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.msksp.2018.06.004","article-title":"Patient education and health literacy","volume":"38","author":"Wittink","year":"2018","journal-title":"Musculoskelet. Sci. Pract."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1080\/00325481.2021.2018257","article-title":"Managing hospitalized patients with a COPD exacerbation: The role of hospitalists and the multidisciplinary team","volume":"134","author":"Amin","year":"2022","journal-title":"Postgrad. Med."},{"key":"ref_22","first-page":"1225","article-title":"Improving outcomes in chronic obstructive pulmonary disease: The role of the interprofessional approach","volume":"10","author":"Amalakuhan","year":"2015","journal-title":"Int. J. Chronic Obstr. Pulm. Dis."},{"key":"ref_23","first-page":"e179","article-title":"Factors Affecting Health Literacy as Related to Asthma and COPD Management: Learning from Patient and Health Care Professional Viewpoints","volume":"5","author":"Poureslami","year":"2021","journal-title":"Health Lit. Res. Pract."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"363","DOI":"10.3132\/pcrj.2007.00075","article-title":"What are the needs of patients following discharge from hospital after an acute exacerbation of chronic obstructive pulmonary disease (COPD)?","volume":"16","author":"Dyer","year":"2007","journal-title":"Prim. Care Respir. J."},{"key":"ref_25","first-page":"1","article-title":"Experiences of living and dying with COPD: A systematic review and synthesis of the qualitative empirical literature","volume":"12","author":"Giacomini","year":"2012","journal-title":"Ont. Health Technol. Assess. Ser."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Hahn-Goldberg, S., Jeffs, L., Troup, A., Kubba, R., and Okrainec, K. (2018). \u201cWe are doing it together\u201d; The integral role of caregivers in a patients\u2019 transition home from the medicine unit. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0197831"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"E478","DOI":"10.9778\/cmajo.20180208","article-title":"Patients\u2019 and caregivers\u2019 perspectives on factors that influence understanding of and adherence to hospital discharge instructions: A qualitative study","volume":"7","author":"Okrainec","year":"2019","journal-title":"CMAJ Open"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1159\/000517032","article-title":"Interventions to Support Informal Caregivers of People with Chronic Obstructive Pulmonary Disease: A Systematic Literature Review","volume":"100","author":"Marques","year":"2021","journal-title":"Respiration"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.2147\/COPD.S107571","article-title":"Involvement of informal caregivers in supporting patients with COPD: A review of intervention studies","volume":"11","author":"Bryant","year":"2016","journal-title":"Int. J. Chronic Obstr. Pulm. Dis."},{"key":"ref_30","first-page":"50","article-title":"Sharing knowledge is the key to success in a patient-physician relationship: How to produce a patient information leaflet on COPD","volume":"69","author":"Scala","year":"2008","journal-title":"Monaldi Arch. Chest Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1159\/000115947","article-title":"The effect of an information leaflet upon knowledge and awareness of COPD in potential sufferers. A randomized controlled study","volume":"76","author":"Roche","year":"2008","journal-title":"Respiration"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.chest.2016.03.041","article-title":"Systematic Review of Errors in Inhaler Use: Has Patient Technique Improved Over Time?","volume":"150","author":"Sanchis","year":"2016","journal-title":"Chest"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"985","DOI":"10.2147\/COPD.S408307","article-title":"Are We Missing the Opportunity to Disseminate GOLD Recommendations Through AECOPD Discharge Letters?","volume":"18","author":"Vergles","year":"2023","journal-title":"Int. J. Chronic Obstr. Pulm. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s12931-017-0710-y","article-title":"Critical inhaler errors in asthma and COPD: A systematic review of impact on health outcomes","volume":"19","author":"Usmani","year":"2018","journal-title":"Respir. Res."},{"key":"ref_35","first-page":"CD001118","article-title":"Print-based self-help interventions for smoking cessation","volume":"1","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1136\/thoraxjnl-2013-204763","article-title":"Determinants and outcomes of physical activity in patients with COPD: A systematic review","volume":"69","author":"Frei","year":"2014","journal-title":"Thorax"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1097\/HCR.0000000000000171","article-title":"Pulmonary Rehabilitation Exercise Prescription in Chronic Obstructive Pulmonary Disease: Review of Selected Guidelines: An Official Statement from the American Association of Cardiovascular and Pulmonary Rehabilitation","volume":"36","author":"Garvey","year":"2016","journal-title":"J. Cardiopulm. Rehabil. Prev."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1164\/rccm.202306-1066ST","article-title":"Pulmonary Rehabilitation for Adults with Chronic Respiratory Disease: An Official American Thoracic Society Clinical Practice Guideline","volume":"208","author":"Rochester","year":"2023","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1016\/j.clnu.2023.04.005","article-title":"Global prevalence of malnutrition in patients with chronic obstructive pulmonary disease: Systematic review and meta-analysis","volume":"42","author":"Deng","year":"2023","journal-title":"Clin. Nutr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"106248","DOI":"10.1016\/j.rmed.2020.106248","article-title":"Managing malnutrition in COPD: A review","volume":"176","author":"Keogh","year":"2021","journal-title":"Respir. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1002\/jpen.2350","article-title":"Undernutrition is associated with mortality, exacerbation, and poorer quality of life in patients with chronic obstructive pulmonary disease: A systematic review with meta-analysis of observational studies","volume":"46","author":"Lima","year":"2022","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_42","first-page":"CD001390","article-title":"Pneumococcal vaccines for preventing pneumonia in chronic obstructive pulmonary disease","volume":"1","author":"Walters","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_43","first-page":"CD002733","article-title":"Influenza vaccine for chronic obstructive pulmonary disease (COPD)","volume":"6","author":"Kopsaftis","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"101337","DOI":"10.1016\/j.arr.2021.101337","article-title":"Effects of influenza vaccination on clinical outcomes of chronic obstructive pulmonary disease: A systematic review and meta-analysis","volume":"68","author":"Bao","year":"2021","journal-title":"Ageing Res. Rev."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Bekkat-Berkani, R., Wilkinson, T., Buchy, P., Dos Santos, G., Stefanidis, D., Devaster, J.-M., and Meyer, N. (2017). Seasonal influenza vaccination in patients with COPD: A systematic literature review. BMC Pulm. Med., 17.","DOI":"10.1186\/s12890-017-0420-8"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"206","DOI":"10.4274\/balkanmedj.2016.1028","article-title":"Influenza and Pneumonia Vaccination Rates and Factors Affecting Vaccination among Patients with Chronic Obstructive Pulmonary Disease","volume":"34","author":"Oktay","year":"2017","journal-title":"Balk. Med. J."},{"key":"ref_47","unstructured":"Narodowy Instytut Zdrowia Publicznego PZH\u2014Pa\u0144stwowy Instytut Badawczy, Zak\u0142ad Epidemiologii Chor\u00f3b Zaka\u017anych i Nadzoru, and G\u0142\u00f3wny Inspektorat Sanitarny, Departament Przeciwepidemiczny i Ochrony Sanitarnej Granic (2025, August 20). Szczepienia Ochronne w Polsce w 2021 Roku, Available online: https:\/\/wwwold.pzh.gov.pl\/oldpage\/epimeld\/2021\/Sz_2021.pdf."},{"key":"ref_48","first-page":"CD011682","article-title":"Self-management interventions including action plans for exacerbations versus usual care in patients with chronic obstructive pulmonary disease","volume":"8","author":"Lenferink","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.2147\/COPD.S155622","article-title":"Support needs of patients with COPD: A systematic literature search and narrative review","volume":"13","author":"Gardener","year":"2018","journal-title":"Int. J. Chronic Obstr. Pulm. Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1479973119838280","DOI":"10.1177\/1479973119838280","article-title":"Mortality and vertebral fracture risk associated with long-term oral steroid use in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis","volume":"16","author":"Chang","year":"2019","journal-title":"Chronic Respir. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"26s","DOI":"10.1183\/09031936.03.00030103","article-title":"Respiratory failure in chronic obstructive pulmonary disease","volume":"47","author":"Calverley","year":"2003","journal-title":"Eur. Respir. J."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e000170","DOI":"10.1136\/bmjresp-2016-000170","article-title":"British Thoracic Society Guideline for oxygen use in adults in healthcare and emergency settings","volume":"4","author":"Howard","year":"2017","journal-title":"BMJ Open Respir. Res."},{"key":"ref_53","first-page":"227","article-title":"Zalecenia Polskiego Towarzystwa Chor\u00f3b P\u0142uc dotycz\u0105ce rozpoznawania i leczenia przewlek\u0142ej obturacyjnej choroby p\u0142uc","volume":"82","author":"Jassem","year":"2014","journal-title":"Pneumonol. Alergol. Pol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1378\/chest.14-1453","article-title":"The Association Between Hospital Readmission and Pulmonologist Follow-up Visits in Patients with COPD","volume":"148","author":"Gavish","year":"2015","journal-title":"Chest"},{"key":"ref_55","unstructured":"Health Quality Ontario (2017). Effect of Early Follow-Up After Hospital Discharge on Outcomes in Patients with Heart Failure or Chronic Obstructive Pulmonary Disease: A Systematic Review. Ont. Health Technol. Assess. Ser., 17, 1\u201337."}],"container-title":["Advances in Respiratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2543-6031\/94\/1\/4\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T05:27:28Z","timestamp":1767763648000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2543-6031\/94\/1\/4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,4]]},"references-count":55,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["arm94010004"],"URL":"https:\/\/doi.org\/10.3390\/arm94010004","relation":{},"ISSN":["2543-6031"],"issn-type":[{"value":"2543-6031","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,4]]}}}