Abstract
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.
Keywords
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References
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Article info
Publication history
Published online: March 16, 2018
Footnotes
Funding: KB received support from the Ohio State University Department of Medicine seed grant award; National Institutes of Health (NIH) L60 MD010857; the University of Colorado, Department of Medicine, Health Services Research Development Grant Award; and the University of Arizona Health Sciences, Strategic Priorities Faculty Initiative Grant. EngineeredCare provided loaner tablets for this study. Tablet applications were developed by EngineeredCare and KB.
Conflicts of Interest: KB has no ownership in EngineeredCare. No employees of EngineeredCare were included with analysis nor development of this manuscript. Otherwise there are no disclosures.
Authorship: All authors had access to data and a role in writing this manuscript.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
