Pilot Randomized Controlled Trial to Reduce Readmission for Heart Failure Using Novel Tablet and Nurse Practitioner Education
Foraker, Randi E.
Lampert, Brent C.
Hershberger, Ray E.
Binkley, Philip F.
Peterson, Pamela N.
Abraham, William T.
AffiliationUniv Arizona, Sarver Heart Ctr, Div Cardiovasc Med
MetadataShow full item record
PublisherELSEVIER SCIENCE INC
CitationBreathett, K., Maffett, S., Foraker, R. E., Sturdivant, R., Moon, K., Hasan, A., ... & Haas, G. (2018). Pilot Randomized Controlled Trial to Reduce Readmission for Heart Failure Using Novel Tablet and Nurse Practitioner Education. The American journal of medicine, 131(8), 974-978. https://doi.org/10.1016/j.amjmed.2018.02.017
JournalAMERICAN JOURNAL OF MEDICINE
Rights© 2018 Elsevier Inc. All rights reserved.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractBACKGROUND: 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.
Note12 month embargo; published online: 16 March 2018
VersionFinal accepted manuscript
SponsorsOhio State University Department of Medicine seed grant award; National Institutes of Health (NIH) [L60 MD010857]; University of Colorado, Department of Medicine, Health Services Research Development Grant Award; University of Arizona Health Sciences, Strategic Priorities Faculty Initiative Grant
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