Cirrhosis
Conditions
Brief summary
To use the PatientBuddy App to reduce 30-day avoidable readmissions in cirrhotic patients using a patient and caregiver perspective.
Detailed description
Specific aim 1: To perform a pilot and feasibility study of disseminating current knowledge of readmission prevention in cirrhosis by using the Patient Buddy App with patient and caregiver interfaces. Eighty subjects (40 cirrhotic inpatients and 40 caregivers) will be enrolled and trained on the Patient Buddy at discharge. The App focuses on daily communication between patient/caregivers and the study team based on previously identified risk factors associated with readmission. The study team will initiate measures to prevent readmission using these communications. A detailed analysis of 30-day readmissions and input of the patients,caregivers and nurse manager will be performed to improve the App. Avoidable readmissions will be defined by a committee of hepatologists who is not part of the study at VCU. Specific aim 2: To incorporate the opinion of key stakeholders (patients, caregivers and case managers) towards improving the Patient Buddy App in the prevention of avoidable readmission in cirrhosis. The input of the key stakeholders and the analysis of readmissions prevented during the pilot study will be used to update the App for preventing avoidable readmissions in future studies
Interventions
None listed
Sponsors
Agency for Healthcare Research and Quality (AHRQ)
Virginia Commonwealth University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Cirrhosis patients ≥21 years of age hospitalized for non-elective reasons * Adult caregiver and the patient living in the same house * Both (caregiver and patient) should be able to complete the Patient Buddy training and evaluation * Discharged home from the hospital * Patients who have VCU as a primary hospital base
Exclusion criteria
* Elective hospitalization * Lack of an adult caregiver * Active alcohol/substance abuse within 1 month of the hospitalization * Unable to perform training or give consent * Patients discharged to hospice, nursing home or extended care facilities * Patients on Hemodialysis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Avoidable Readmission | 30 days | Avoidable Readmissions within 30 days. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Patient Buddy Subject Only/Not Dyad Subjects will be given iphones loaded with the App that will be used to enter medications, issues and orientation questions. They will be seen at day 15 and day 30 and will receive a phone call day 7 and day 21 inquiring about issues that would need medical attention | 116 |
| Standard of Care Subject Only/Not Dyad Subjects randomized to standard of care and not the Buddy App | 116 |
| Total | 232 |
Baseline characteristics
| Characteristic | Patient Buddy Subject Only/Not Dyad | Total | Standard of Care Subject Only/Not Dyad |
|---|---|---|---|
| Age, Continuous | 59.1 Years STANDARD_DEVIATION 12.38 | 58.8 Years STANDARD_DEVIATION 10.6 | 58.42 Years STANDARD_DEVIATION 8.89 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 6 Participants | 12 Participants | 6 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 110 Participants | 220 Participants | 110 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 53 Participants | 89 Participants | 36 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 63 Participants | 143 Participants | 80 Participants |
| Region of Enrollment United States | 116 participants | 232 participants | 116 participants |
| Sex: Female, Male Female | 58 Participants | 98 Participants | 40 Participants |
| Sex: Female, Male Male | 58 Participants | 134 Participants | 76 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 116 | 0 / 116 |
| other Total, other adverse events | 0 / 116 | 0 / 116 |
| serious Total, serious adverse events | 0 / 116 | 0 / 116 |
Outcome results
Primary
Avoidable Readmission
Avoidable Readmissions within 30 days.
Time frame: 30 days
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Patient Buddy Subject Only/Not Dyad | Avoidable Readmission | 23 Number of Avoidable Readmissions |
| Standard of Care Subject Only/Not Dyad | Avoidable Readmission | 12 Number of Avoidable Readmissions |