Pilot Randomized Controlled Trial to Reduce Readmission for Heart Failure Using Novel Tablet and Nurse Practitioner Education

被引：17

作者：

Breathett, Khadijah ^{[1
]}

Maffett, Scott ^{[2
]}

Foraker, Randi E. ^{[3
]}

Sturdivant, Rod ^{[4
]}

Moon, Kristina ^{[5
]}

Hasan, Ayesha ^{[2
]}

Franco, Veronica ^{[2
]}

Smith, Sakima ^{[2
]}

Lampert, Brent C. ^{[2
]}

Emani, Sitaramesh ^{[2
]}

Haas, Garrie ^{[2
]}

Kahwash, Rami ^{[2
]}

Hershberger, Ray E. ^{[2
]}

Binkley, Philip F. ^{[2
]}

Helmkamp, Laura ^{[6
]}

Colborn, Kathryn ^{[6
]}

Peterson, Pamela N. ^{[7
,8
]}

Sweitzer, Nancy ^{[1
]}

Abraham, William T. ^{[2
]}

机构：

[1] Univ Arizona, Sarver Heart Ctr, Div Cardiovasc Med, 1501 N Campbell Ave,POB 245046, Tucson, AZ 85724 USA

[2] Ohio State Univ, Wexner Med Ctr, Div Cardiovasc Med, Columbus, OH 43210 USA

[3] Washington Univ, Sch Med, Inst Informat, St Louis, MO USA

[4] Azusa Pacific Univ, Dept Math & Phys, Azusa, CA USA

[5] Univ Wisconsin, Div Cardiol, Madison, WI USA

[6] Univ Colorado, Adult & Child Consortium Hlth Outcomes Res & Deli, Aurora, CO USA

[7] Univ Colorado, Div Cardiol, Denver, CO 80202 USA

[8] Denver Hlth Med Ctr, Denver, CO 80202 USA

来源：

AMERICAN JOURNAL OF MEDICINE | 2018年 / 131卷 / 08期

基金：

美国国家卫生研究院;

关键词：

Educational technology; Heart failure; Nurse practitioner; Patient education; Readmission; TASK-FORCE; GUIDELINES;

D O I：

10.1016/j.amjmed.2018.02.017

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND: Heart failure education programs are not standardized. The best form of education is unclear. We evaluated whether addition of a novel tablet application to nurse practitioner (NP) education was superior to NP education alone in reducing 30-day readmission after heart failure hospitalization. METHODS: From February 2015-March 2016. patients admitted to a quaternary academic center with primary diagnosis of heart failure were randomized to 1) treatment - NP education plus tablet application (interactive conditional logic program that flags patient questions to medical staff), or 2) control - NP education. The primary outcome was reduction in 30-day readmission rate. Secondary outcomes included satisfaction and education assessed via survey. RESULTS: Randomization included 60 patients to treatment and 66 to control. A total of 13 patients withdrew prior to intervention (treatment n = 4, control n = 1) or were lost to follow-up (treatment n = 3, control n = 5). The 30-day readmission rate trended lower for treatment compared with control, but results were not statistically significant (13.2% [7/53]. 26.7% [16/60]. respectively, P = .08). Similarly, satisfaction trended higher with treatment than control (P = .08). Treatment patients rated explanations from their physicians higher than control (Always: 83.7%. 55.8%, respectively, P = .01). CONCLUSIONS: NP education plus tablet use was not associated with significantly lower 30-day readmission rates in comparison with NP alone, but a positive trend was seen. Patient satisfaction trended higher and heart failure explanations were better with NP education plus tablet. A larger study is needed to determine if NP education plus tablet reduces readmission rates following heart failure admission. (C) 2018 Elsevier Inc. All rights reserved.

引用

页码：974 / 978

页数：5

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