The patient buddy app can potentially prevent hepatic encephalopathy-related readmissions
The patient buddy app can potentially prevent hepatic encephalopathy-related readmissions
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DOI：
10.1111/liv.13494
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发表时间：
2017-12-01
影响因子：
6.7
通讯作者：
Bajaj, Jasmohan S.
中科院分区：
文献类型：
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作者：
Ganapathy, Dinesh;Acharya, Chathur;Bajaj, Jasmohan S.
背景与目的：再入院是肝硬化患者的主要负担。通过患者和护理人员的参与，可以避免一定比例的肝硬化再入院，特别是因为肝性脑病（HE）。我们的目的是确定使用患者好友应用程序的可行性及其对30天再入院的影响，通过参与和教育肝硬化住院患者和照顾者在pilot study.Methods：肝硬化住院患者与照顾者入组并随访30天后出院。在单独分配的装有患者伙伴的设备上，他们接受了关于输入药物依从性、每日钠摄入量和体重以及每周认知（EncephalApp_Stroop）和跌倒风险评估的培训，并接受了关于水肿相关症状的教育。这些由临床团队通过患者伙伴加载的iPad每天监测。该应用程序在患者/护理人员和临床团队之间发送关于依从性和临界值的自动警报。在30天，总，和HE相关的入院进行了分析，以及教育values.Results的可行性和反馈：40例患者和40名照顾者参加。17例患者在30天内再次入院，但无一例因HE而再次入院。通过应用程序生成的警报，鼓励早期门诊干预，预防了8例潜在的HE相关再入院。护理人员和患者在数据输入方面一致，但有6人未完成数据输入。大多数受访者评价的应用程序有利的教育value.Conclusions：在这个概念验证试验中，使用病人伙伴是可行的，在最近出院的肝硬化患者和他们的照顾者。使用该应用程序后，可能避免了8例HE相关再入院。
Background & Aims: Readmissions are a major burden in cirrhosis. A proportion of readmissions in cirrhosis, especially because of hepatic encephalopathy (HE) could be avoided through patient and caregiver engagement. We aimed to define the feasibility of using the Patient Buddy App and its impact on 30-day readmissions by engaging and educating cirrhotic inpatients and caregivers in a pilot study.Methods: Cirrhotic inpatients with caregivers were enrolled and followed for 30 days post-discharge. On separately assigned devices loaded with Patient Buddy, they were trained on entering medication adherence, daily sodium intake and weights, and weekly cognitive (EncephalApp_Stroop) and fall-risk assessment and were educated regarding cirrhosis-related symptoms. These were monitored daily through a Patient Buddy loaded iPad by the clinical team. The App sent automatic alerts between patient/caregivers and clinical team regarding adherence and critical values. At 30 days, total, and HE-related admissions were analysed as well as the feasibility and feedback regarding educational values.Results: Forty patients and 40 caregivers were enrolled. Seventeen patients were readmitted within 30-days but none for HE. Eight potential HE-related readmissions were prevented through App-generated alerts that encouraged early outpatient interventions. Caregivers and patients were concordant in data entry but six did not complete data entries. Most respondents rated the App favourably for its educational value.Conclusions: In this proof-of-concept trial, the use of Patient Buddy is feasible in recently discharged patients with cirrhosis and their caregivers. Eight HE-related readmissions were potentially avoided after the use of the App.