A randomised controlled trial assessing the efficacy of an electronic discharge communication tool for preventing death or hospital readmission

2017 ◽  
Vol 26 (12) ◽  
pp. 993-1003 ◽  
Author(s):  
Maria J Santana ◽  
Jayna Holroyd-Leduc ◽  
Danielle A Southern ◽  
Ward W Flemons ◽  
Maeve O’Beirne ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Hospital Readmission ◽  
Controlled Trial ◽  
Communication Tool ◽  
Randomised Controlled ◽  
Discharge Communication

scholarly journals Prospective economic evaluation of an electronic discharge communication tool: analysis of a randomised controlled trial

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e019139 ◽  
Author(s):  
Laura K Sevick ◽  
Maria-Jose Santana ◽  
William A Ghali ◽  
Fiona Clement
Keyword(s):  
Economic Evaluation ◽  
Randomised Controlled Trial ◽  
Usual Care ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Control Group ◽  
Communication Tool ◽  
Randomised Controlled ◽  
The Cost ◽  
Discharge Communication

ObjectiveTo complete an economic evaluation within a randomised controlled trial (RCT) comparing the use of an electronic discharge communication tool (eDCT) compared with usual care.SettingPatients being discharged from a single tertiary care centre’s internal medicine Medical Teaching Units.ParticipantsBetween January 2012 and December 2013, 1399 patients were randomised to a discharge mechanism. Forty-five patients were excluded from the economic evaluation as they did not have data for the index hospitalisation cost; 1354 patients contributed to the economic evaluation.InterventioneDCT generated at discharge containing structured content on reason for admission, details of the hospital stay, treatments received and follow-up care required. The control group was discharged via traditional dictation methods.Primary and secondary outcome measuresThe primary economic outcome was the cost per quality-adjusted life year (QALY) gained. Secondary outcomes included the cost per death avoided and the cost per readmission avoided.ResultsThe average transcription cost was $C22.28 per patient, whereas the estimated cost of the eDCT was $C13.33 per patient. The cost per QALY gained was $C239 933 in the eDCT arm compared with usual care due to the very small gains in effectiveness and approximately $C800difference in resource utilisation costs. The bootstrap analyses resulted in eDCT being more effective and more costly in 29.2% of samples, less costly and more effective in 29.2% of samples, less effective and more costly in 23.9% of samples and finally, less costly and less effective in 17.7% of samples.ConclusionsThe eDCT reduced per patient costs of the generation of discharge summaries. The bootstrap estimates demonstrate considerable uncertainty supporting the finding of neutrality reported in the clinical component of the RCT. The immediate transcription cost savings and previously documented provider and patient satisfaction may increase the impetus for organisations to invest in such systems, provided they have a foundation of eHealth infrastructure and readiness.Trial registration numberNCT01402609.

scholarly journals Danish Evaluation of Your Heart Forecast (DANY) - Study Protocol for a Randomised Controlled Trial on an Interactive Risk-communication Tool aimed at improving High Blood Pressure Patients’ adherence.

2019 ◽  
Author(s):  
Anders Elkær Jensen ◽  
Jens Søndergaard ◽  
Niels Kristian Kjær ◽  
Rod Jackson ◽  
Jesper Bo Nielsen
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Health Literacy ◽  
Randomised Controlled Trial ◽  
Risk Communication ◽  
Controlled Trial ◽  
Pressure Control ◽  
Communication Tool ◽  
Hypertensive Patients ◽  
Randomised Controlled

Abstract Background To improve communication of risk messages, they must be communicated in a way that is understandable and relevant to the patient. Communicating risk of cardio-vascular-disease is a complex and individualised task, since the risk itself is a combination of multiple personal risk factors. Raised blood pressure is but one of these risk factors. In Denmark, one third of hypertensive patients are adequately treated, with regards to national guidelines. One reason for this meagre status is low treatment adherence, and tools with documented effects for increasing patient adherence are limited. Our objective is to evaluate the effect of a personalised, interactive and dynamic risk-assessment and risk-communication tool: “Your Heart Forecast” on blood pressure control, primary non-compliance, health literacy and patient empowerment.Methods Cluster-randomised controlled trial in general practice. Effect measures are adherence, blood pressure, lipid levels and empowerment at inclusion and after 6 and 12 months. To identify other benefits or possible adverse effects of the intervention, qualitative interviews will be conducted with a subgroup of patients. Discussion The investigators will explore effects of Your Heart Forecast on patients’ health literacy, adherence, empowerment and blood pressure control. The DANish evaluation of Your heart forecast (DANY) project will be the first to rigorously evaluate effects of YHF in Denmark and to link adherence of hypertensive patients exposed to Your Heart Forecast with the national databases of prescriptions and health services provided.

scholarly journals Home-based pulmonary rehabilitation early after hospitalisation in COPD (early HomeBase): protocol for a randomised controlled trial

2021 ◽  
Vol 8 (1) ◽  
pp. e001107
Author(s):  
Narelle S Cox ◽  
Aroub Lahham ◽  
Christine F McDonald ◽  
Ajay Mahal ◽  
Paul O'Halloran ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Usual Care ◽  
Hospital Discharge ◽  
Hospital Readmission ◽  
Pulmonary Rehabilitation ◽  
Controlled Trial ◽  
Control Group ◽  
Home Based ◽  
Randomised Controlled

IntroductionChronic obstructive pulmonary disease (COPD) is characterised by exacerbations of respiratory disease, frequently requiring hospital admission. Pulmonary rehabilitation can reduce the likelihood of future hospitalisation, but programme uptake is poor. This study aims to compare hospital readmission rates, clinical outcomes and costs between people with COPD who undertake a home-based programme of pulmonary rehabilitation commenced early (within 2 weeks) of hospital discharge with usual care.MethodsA multisite randomised controlled trial, powered for superiority, will be conducted in Australia. Eligible patients admitted to one of the participating sites for an exacerbation of COPD will be invited to participate. Participants will be randomised 1:1. Intervention group participants will undertake an 8-week programme of home-based pulmonary rehabilitation commencing within 2 weeks of hospital discharge. Control group participants will receive usual care and a weekly phone call for attention control. Outcomes will be measured by a blinded assessor at baseline, after the intervention (week 9–10 posthospital discharge), and at 12 months follow-up. The primary outcome is hospital readmission at 12 months follow-up.Ethics and disseminationHuman Research Ethics approval for all sites provided by Alfred Health (Project 51216). Findings will be published in peer-reviewed journals, conferences and lay publications.Trial registration numberACTRN12619001122145.

scholarly journals Danish Evaluation of Your Heart Forecast (DANY) - Study Protocol for a Cluster Randomised Controlled Trial on an Interactive Risk-communication Tool aimed at improving High Blood Pressure Patients’ adherence.

2019 ◽  
Author(s):  
Anders Elkær Jensen ◽  
Jens Søndergaard ◽  
Niels Kristian Kjær ◽  
Rod Jackson ◽  
Jesper Bo Nielsen
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Pressure Control ◽  
Communication Tool ◽  
Hypertensive Patients ◽  
Cluster Randomised ◽  
Randomised Controlled

Abstract Background To improve communication of risk messages, they must be communicated in a way that is understandable and relevant to the patient. Communicating risk of cardio-vascular-disease is a complex and individualised task, since the risk itself is a combination of multiple personal risk factors. Raised blood pressure is but one of these risk factors. In Denmark, one third of hypertensive patients are adequately treated, with regards to national guidelines. One reason for this meagre status is low treatment adherence, and tools with documented effects for increasing patient adherence are limited. Our objective is to evaluate the effect of a personalised, interactive and dynamic risk-assessment and risk-communication tool: “Your Heart Forecast” on blood pressure control, primary non-compliance, health literacy and patient empowerment.Methods Cluster-randomised controlled trial in general practice. Effect measures are adherence, blood pressure, lipid levels and empowerment at inclusion and after 6 and 12 months. To identify other benefits or possible adverse effects of the intervention, qualitative interviews will be conducted with a subgroup of patients. Discussion The investigators will explore effects of Your Heart Forecast on patients’ health literacy, adherence, empowerment and blood pressure control. The DANish evaluation of Your heart forecast (DANY) project will be the first to rigorously evaluate effects of YHF in Denmark and to link adherence of hypertensive patients exposed to Your Heart Forecast with the national databases of prescriptions and health services provided.

scholarly journals Danish Evaluation of Your Heart Forecast (DANY): study protocol for a cluster randomised controlled trial on an interactive risk-communication tool aimed at improving adherence of patients with high blood pressure

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Anders Elkær Jensen ◽  
Jens Søndergaard ◽  
Niels Kristian Kjær ◽  
Rod Jackson ◽  
Jesper Bo Nielsen
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Pressure Control ◽  
Communication Tool ◽  
Hypertensive Patients ◽  
Cluster Randomised ◽  
Randomised Controlled

Abstract Background To improve communication of risk messages, they must be communicated in a way that is understandable and relevant to the patient. Communicating risk of cardiovascular disease is a complex and individualised task, since the risk itself is a combination of multiple personal risk factors. Raised blood pressure is but one of these risk factors. In Denmark, only one-third of hypertensive patients are adequately treated, with regards to national clinical guidelines. One reason for this problem is low treatment adherence; tools with documented effects for increasing adherence of patients are limited. Our objective is to evaluate the effect of a personalised, interactive and dynamic risk-assessment and risk-communication tool: ‘Your Heart Forecast’ (YHF) on blood pressure control, primary non-compliance, health literacy and patient empowerment. Methods Cluster-randomised controlled trial in general practice. Effect measures are adherence, blood pressure, lipid levels and empowerment at inclusion and after 6 and 12 months. To identify other benefits or possible adverse effects of the intervention, qualitative interviews will be conducted with a subgroup of patients. Discussion The investigators will explore effects of Your Heart Forecast on patients’ health literacy, adherence, empowerment and blood pressure control. The DANish evaluation of Your heart forecast (DANY) project will be the first to rigorously evaluate effects of YHF in Denmark and to link adherence of hypertensive patients exposed to YHF with the national databases of prescriptions and health services provided. Trial registration Clinicaltrials.gov, NCT04058847. Registered on 16 August 2019.

Self-care educational intervention to reduce hospitalisations in heart failure: A randomised controlled trial

2017 ◽  
Vol 17 (2) ◽  
pp. 178-185 ◽  
Author(s):  
M Boyde ◽  
R Peters ◽  
N New ◽  
R Hwang ◽  
T Ha ◽  
...  
Keyword(s):  
Heart Failure ◽  
Randomised Controlled Trial ◽  
Educational Intervention ◽  
Hospital Readmission ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Care ◽  
Control Group ◽  
Patients With Heart Failure ◽  
Randomised Controlled

Background: A variety of educational interventions have been implemented to assist patients with heart failure to maintain their own health, develop self-care behaviours and decrease readmissions. Aims: The purpose of this study was to determine the effectiveness of a multimedia educational intervention for patients with heart failure in reducing unplanned hospital readmissions. Methods: The study, a randomised controlled trial in a large tertiary referral hospital in Australia, recruited 200 patients. Patients diagnosed with heart failure were randomly allocated 1:1 to usual education or a multimedia educational intervention. The multimedia approach began with an individual needs assessment to develop an educational plan. The educational intervention included viewing a DVD, and verbal discussion supported by a written manual with a teach-back evaluation strategy. The primary outcome was all-cause unplanned hospital readmission at 28 days, three months and 12 months post-recruitment. The secondary outcomes were changes in knowledge and self-care behaviours at three months and 12 months post-recruitment. Results: At 12 months, data on 171 participants were analysed. There were 24 participants who had an unplanned hospital readmission in the intervention group compared to 44 participants in the control group ( p=0.005). The self-care educational intervention reduced the risk of readmission at 12 months by 30% (relative risk: 0.703; 95% confidence interval: 0.548–0.903). Conclusion: A targeted multimedia educational intervention can be effective in reducing all-cause unplanned readmissions for people with heart failure.

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