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 readmissionafter 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.
RCT Entities:
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 flagspatient 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.
Authors: Clyde W Yancy; Mariell Jessup; Biykem Bozkurt; Javed Butler; Donald E Casey; Mark H Drazner; Gregg C Fonarow; Stephen A Geraci; Tamara Horwich; James L Januzzi; Maryl R Johnson; Edward K Kasper; Wayne C Levy; Frederick A Masoudi; Patrick E McBride; John J V McMurray; Judith E Mitchell; Pamela N Peterson; Barbara Riegel; Flora Sam; Lynne W Stevenson; W H Wilson Tang; Emily J Tsai; Bruce L Wilkoff Journal: Circulation Date: 2013-06-05 Impact factor: 29.690
Authors: Khadijah Breathett; Rachel D'Amico; T M Ayodele Adesanya; Stefanie Hatfield; Shannon Willis; Rodney X Sturdivant; Randi E Foraker; Sakima Smith; Philip Binkley; William T Abraham; Pamela N Peterson Journal: Circ Heart Fail Date: 2017-06 Impact factor: 8.790
Authors: Robb D Kociol; Eric D Peterson; Bradley G Hammill; Kathryn E Flynn; Paul A Heidenreich; Ileana L Piña; Barbara L Lytle; Nancy M Albert; Lesley H Curtis; Gregg C Fonarow; Adrian F Hernandez Journal: Circ Heart Fail Date: 2012-08-28 Impact factor: 8.790
Authors: Clyde W Yancy; James L Januzzi; Larry A Allen; Javed Butler; Leslie L Davis; Gregg C Fonarow; Nasrien E Ibrahim; Mariell Jessup; JoAnn Lindenfeld; Thomas M Maddox; Frederick A Masoudi; Shweta R Motiwala; J Herbert Patterson; Mary Norine Walsh; Alan Wasserman Journal: J Am Coll Cardiol Date: 2017-12-22 Impact factor: 24.094
Authors: Christoph Becker; Samuel Zumbrunn; Katharina Beck; Alessia Vincent; Nina Loretz; Jonas Müller; Simon A Amacher; Rainer Schaefert; Sabina Hunziker Journal: JAMA Netw Open Date: 2021-08-02