Abstract Rationale The BRIDGE-COPD study evaluates whether the implementation of post-exacerbation transition bundle under clinical audit can improve the peri-discharge management and clinical outcomes of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in China’s county-level hospitals. Here we report interim results at Week 12. Methods BRIDGE-COPD (NCT06646419) is a prospective, multi-center, cluster-randomized, behavioral intervention study. A total of 18 secondary and 18 tertiary county-level hospitals were enrolled and randomized (2:1) to the intervention or the control group. From these sites, COPD patients aged 40-80 years with ≥2 moderate or ≥ 1 severe exacerbations in the past year and a COPD Assessment Test (CAT) score ≥10 were included; patients having continuous triple inhalation therapy for ≥6 months or those in the stable phase of COPD were excluded. The intervention group underwent guideline education, transition bundle implementation, and clinical audit, while the control group maintained current clinical practice. This interim analysis was conducted when 50% of patients completed Visit 1 (at Week 12). Results During 13th November 2024-14th July 2025, 1,218 patients were enrolled, and 688 patients completed Visit 1 (intervention: n = 423; control: n = 265). At Week 12, the mean (SD) change from baseline in CAT score was -7.3 (6.57) in the intervention group and was -5.5 (7.25) in the control group, and the mean (SD) change from baseline in FEV1 was +0.112 (0.2751) L and +0.078 (0.3160) L, respectively (Table 1). At Week 12, 84.2% (356/423) of patients in the intervention group and 78.9% (209/265) in the control group were receiving inhalation therapy consistent with guideline for stable COPD. In the intervention group, 45.4% (189/416) of patients correctly operated the inhaler at Week 12, compared to 54.3% (226/416) at baseline. In the intervention group, 92.1% (387/420) of the patients and 99.3% (417/420) of their physicians achieved ≥75% transition bundle completion at Week 12. Conclusion This interim analysis provided early short-term evidence on the effectiveness of the intervention. Greater improvements in symptom control and lung function were observed in the intervention group, likely driven by transition bundle implementation and guideline-aligned inhalation therapy. The proportion of patients correctly operating their inhaler device decreased at Week 12, potentially attributed to patients gradually forgetting correct inhaler technique over time, underscoring the necessity of continuous patient education and inhaler technique reinforcement. Full analysis upon study completion among all patients will assess its long-term impact on clinically important deterioration, including moderate/severe exacerbations, lung function decline, and symptom worsening. This abstract is funded by: AstraZeneca China
Yang et al. (Fri,) studied this question.
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