Purpose: Diabetes transitional care from the inpatient to outpatient setting is understudied. This study evaluated the effect of inpatient pharmacist discharge counseling on outpatient diabetes medication adherence.
Research Methods: Prospective, randomized, controlled study compared pharmacist discharge counseling (intervention) with usual patient care (control) in 127 patients with established diabetes and an A1C ≥8% who had a provider and medications filled within the county health system. The primary outcome was diabetes medication adherence rate measured using the prescription of days covered (PDC) method.
Results: Patients in the intervention, compared with control group, had greater diabetes medication adherence rate 150 days after discharge (55.2% vs 34.8%; P = .002), rate of follow-up visits (60.5% vs 43.9%; P = .01) and reduction in A1C (-1.97% vs +0.114%; P = .003). Being in the intervention group and having greater adherence with follow-up visits correlated independently with lower follow-up A1C.
Conclusion: Transitional care in the form of inpatient education geared to improve self-management after hospital discharge. This may serve as a paradigm to improve outpatient adherence rate with medications, follow-up visits, and A1C reduction.
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http://dx.doi.org/10.1177/0897190012451907 | DOI Listing |
Eur J Heart Fail
January 2025
Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Aims: While it is widely accepted that intravenous (IV) iron improves functional capacity, symptoms, and cardiovascular outcomes in patients with heart failure (HF) with reduced ejection fraction (HFrEF) diagnosed with iron deficiency (ID), three recently published cardiovascular outcome trials (AFFIRM-AHF, IRONMAN and HEART-FID) of IV iron supplementation in HF failed to demonstrate a significant benefit on their respective primary endpoints. Dosing of IV iron after the initial correction of baseline ID - by design or as a result of trial circumstances - was relatively low (i.e.
View Article and Find Full Text PDFBMC Health Serv Res
January 2025
Pain Research Unit, Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Evidence-based treatment of chronic pain requires a multidisciplinary approach grounded in the biopsychosocial model. Implementing this approach within health systems relies on its acceptance by both healthcare providers and patients. While pioneering multidisciplinary pain clinics can serve as a model for implementation, a systematic effort is needed to share knowledge effectively and broadly.
View Article and Find Full Text PDFJMIR Public Health Surveill
January 2025
Frailty Research Center, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, United States.
Background: The long-term economic impact of frailty measured at the beginning of elderhood is unknown.
Objective: The objective of our study was to examine the association between an individual's frailty index at 66 years of age and their health care costs and utilization over 10 years.
Methods: This retrospective cohort study included 215,887 Koreans who participated in the National Screening Program for Transitional Ages at 66 years of age between 2007-2009.
Health Serv Res
January 2025
College of Nursing, Marquette University, Milwaukee, Wisconsin, USA.
Objective: To assess how patient and caregiver factors influence caregiver readiness for hospital discharge in palliative care patients.
Study Setting And Design: This transitional care study uses cross-sectional data from a randomized controlled trial conducted from 2018 to 2023 testing an intervention for caregivers of hospitalized adult patients with a serious or life-limiting illness who received a palliative care consult prior to transitioning out of the hospital.
Data Sources And Analytical Sample: Caregiver readiness was measured with the Family Readiness for Hospital Discharge Scale (n = 231).
Int J Qual Health Care
January 2025
Department of Medicine, Johns Hopkins University, 1830 E. Monument Street, Baltimore, MD 21287, USA.
Background: Hospitals face mounting pressure to reduce unplanned utilization amid rising healthcare demands from an aging population. The Case management for At-Risk patients in the Emergency Department (CARED) program is among the first ED transitional care strategies to focus on both frail older adults and emergency department (ED) re-attenders to reduce acute hospital utilization. This study aims to evaluate the effectiveness of the CARED program in reducing hospital (re)admissions and ED re-attendances within 30- and 60 days post-discharge.
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