Effectiveness of a Diabetes-Focused Electronic Discharge Order Set and Postdischarge Nursing Support Among Poorly Controlled Hospitalized Patients: Randomized Controlled Trial

Autor: Audrey White, David Bradley, Elizabeth Buschur, Cara Harris, Jacob LaFleur, Michael Pennell, Adam Soliman, Kathleen Wyne, Kathleen Dungan
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: JMIR Diabetes, Vol 7, Iss 3, p e33401 (2022)
Druh dokumentu: article
ISSN: 2371-4379
DOI: 10.2196/33401
Popis: BackgroundAlthough the use of electronic order sets has become standard practice for inpatient diabetes management, there is limited decision support at discharge. ObjectiveIn this study, we assessed whether an electronic discharge order set (DOS) plus nurse follow-up calls improve discharge orders and postdischarge outcomes among hospitalized patients with type 2 diabetes mellitus. MethodsThis was a randomized, open-label, single center study that compared an electronic DOS and nurse phone calls to enhanced standard care (ESC) in hospitalized insulin-requiring patients with type 2 diabetes mellitus. The primary outcome was change in glycated hemoglobin (HbA1c) level at 24 weeks after discharge. The secondary outcomes included the completeness and accuracy of discharge prescriptions related to diabetes. ResultsThis study was stopped early because of feasibility concerns related to the long-term follow-up. However, 158 participants were enrolled (DOS: n=82; ESC: n=76), of whom 155 had discharge data. The DOS group had a greater frequency of prescriptions for bolus insulin (78% vs 44%; P=.01), needles or syringes (95% vs 63%; P=.03), and glucometers (86% vs 36%; P
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