A 65-year-old man is treated in the emergency department (ED) for an acute exacerbation of chronic obstructive pulmonary disease (COPD). His dyspnea has improved, and he is now clinically stable for discharge on tiotropium and albuterol inhalers. According to evidence-based discharge bundles for COPD, which intervention is the highest priority to reduce the risk of early readmission?
Arrange a follow-up appointment with the primary care provider within 7-10 days
Use teach-back to confirm the patient can demonstrate correct inhaler technique and state when to use each medication
Assess the need for and order home oxygen therapy based on overnight oximetry
Provide written smoking-cessation materials and contact information for a community program
The most critical intervention is to use the teach-back method so the patient can correctly demonstrate inhaler technique and articulate when to use each prescribed medication. Correct inhaler use and understanding of maintenance versus rescue therapy directly influence symptom control and early relapse; deficiencies in technique are common and strongly linked to avoidable readmissions. Early follow-up, assessment for home oxygen, and smoking-cessation counseling are important but have less immediate impact if the patient cannot self-administer the medications that keep the airways open.
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