1215-P: Qualitative Assessment of a Novel Intervention to Reduce Hospital Readmission Risk among Patients with Diabetes
| Autor: | Dominic Recco, Neil Kondamuri, Daniel J. Rubin, Felicia R. Dillard, Andrew Deak, Samuel Tanner, Bonnie S. Albury, Emily Brzana, Madeline Tivon, Amy Iwamaye, Shaneisha Allen, Cherie Lisa Vaz, Samantha Watts |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Hospital readmission Hospitalized patients business.industry Endocrinology Diabetes and Metabolism medicine.disease Hospital care law.invention Randomized controlled trial law Diabetes mellitus Intervention (counseling) Emergency medicine Internal Medicine medicine Thematic analysis business Patient education |
| Zdroj: | Diabetes. 69 |
| ISSN: | 1939-327X 0012-1797 |
| DOI: | 10.2337/db20-1215-p |
| Popis: | Patients with diabetes (DM) are at higher risk of hospital readmission within 30 days of discharge (30dRe) than patients without DM. We previously reported quantitative results of a pilot RCT testing a novel intervention, the Diabetes Transition of Hospital Care (DiaTOHC) Program, designed to reduce readmission risk. The current study qualitatively assessed the intervention. We identified 115 hospitalized patients with DM at high risk for 30dRe using the Diabetes Early Readmission Risk Indicator (DERRITM). A total of 58 patients were randomized to the DiaTOHC Program, which consisted of program-specific inpatient DM education, coordination of care, telephonic post-discharge support by a nurse (Navigator), and an A1c-based algorithm to adjust DM therapy. At 5 to 12 weeks post-discharge, intervention patients were interviewed until saturation, resulting in 22 interviews. Study staff were also interviewed. We performed thematic analysis of the interviews. We identified 5 themes: (1) the intervention increased agency over DM self-management, (2) Navigator phone calls reinforced patient education and provided subjects with accountability, (3) it was difficult for patients to engage in DM education in the hospital, (4) perceived lack of control was associated with readmission, and (5) most patients were unable to correctly interpret their A1c level. Patients with baseline A1c >8% were less likely to review the educational materials, had more difficulty adhering to discharge instructions, and reported more extreme blood glucose levels. However, this subgroup also reported making more improvements in diet and medication adherence due to the intervention. The DiaTOHC intervention may instill a sense of personal responsibility for DM management after hospital discharge. Patients and staff valued the combination of education, care coordination, and follow up. All 3 components may interact synergistically with medical management to reduce readmission risk. Disclosure S. Tanner: None. E. Brzana: None. A. Deak: None. D. Recco: None. M. Tivon: None. F.R. Dillard: None. S. Watts: None. N. Kondamuri: None. B.S. Albury: None. S. Allen: None. A. Iwamaye: None. C. Vaz: None. D.J. Rubin: None. Funding National Institutes of Health (K23DK102963) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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