Feasibility of using a transition diabetes team to commence injectable therapies postdischarge from a tertiary hospital : a pilot, randomised controlled trial
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
OBJECTIVES: This study aimed to investigate if the use of a transition team was feasible for patients with diabetes being discharged from hospital on injectable diabetes therapies.
DESIGN: Pilot, randomised controlled trial.
SETTING: The trial was conducted between 2014 and 2016 conjointly by a tertiary referral hospital and a community healthcare provider.
PARTICIPANTS: Hospital inpatients (n=105) on new injectable diabetes therapies were randomised 1:1 to transition team or standard care. The transition team received in-home diabetes education 24-48 hours postdischarge, with endocrinologist review 2-4 weeks and 16 weeks postdischarge.
MAIN OUTCOME MEASURES: The primary outcome was feasibility, defined by percentage of patients successfully receiving the intervention. Secondary outcomes included safety, defined by hospital readmission and emergency department presentations within 16 weeks postrandomisation, and treatment satisfaction, measured using Diabetes Treatment Satisfaction Questionnaire (DTSQ). Exploratory outcomes included length of stay (LOS) and change in haemoglobin A1c (HbA1c) throughout the study.
RESULTS: The intervention was deemed feasible (85% (95% CI 73% to 94%)). No difference in safety between groups was detected. No difference in change in HbA1c between groups was detected (standard care median HbA1c -1.5% (IQR -3.7% to -0.2%) vs transition team median HbA1c -1.9% (IQR -3.8% to -0.2%), p=0.83). There was a trend towards reduced LOS in the transition team group (per protocol, standard care median LOS 8 (IQR 5.5-12); transition team median LOS 6 (IQR 3-12), p=0.06). There was a significant improvement in patient satisfaction in the transition team (standard care median 10.5 (IQR 8.5-16); transition team DTSQ change version median 15 (IQR 10-17.5), p=0.047), although interpretability is limited by missing data.
CONCLUSION: This study demonstrated that the use of a novel transition diabetes team is a feasible alternative model of care.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2019 |
|---|---|
| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
|---|---|
| Enthalten in: |
BMJ open - 9(2019), 9 vom: 20. Sept., Seite e023583 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Pyrlis, Felicity [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Diabetes |
|---|
| Anmerkungen: |
Date Completed 30.09.2020 Date Revised 30.09.2020 published: Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1136/bmjopen-2018-023583 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM301507090 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM301507090 | ||
| 003 | DE-627 | ||
| 005 | 20231226200605.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2019 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1136/bmjopen-2018-023583 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1005.xml |
| 035 | |a (DE-627)NLM301507090 | ||
| 035 | |a (NLM)31542730 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Pyrlis, Felicity |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Feasibility of using a transition diabetes team to commence injectable therapies postdischarge from a tertiary hospital |b a pilot, randomised controlled trial |
| 264 | 1 | |c 2019 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 30.09.2020 | ||
| 500 | |a Date Revised 30.09.2020 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a OBJECTIVES: This study aimed to investigate if the use of a transition team was feasible for patients with diabetes being discharged from hospital on injectable diabetes therapies | ||
| 520 | |a DESIGN: Pilot, randomised controlled trial | ||
| 520 | |a SETTING: The trial was conducted between 2014 and 2016 conjointly by a tertiary referral hospital and a community healthcare provider | ||
| 520 | |a PARTICIPANTS: Hospital inpatients (n=105) on new injectable diabetes therapies were randomised 1:1 to transition team or standard care. The transition team received in-home diabetes education 24-48 hours postdischarge, with endocrinologist review 2-4 weeks and 16 weeks postdischarge | ||
| 520 | |a MAIN OUTCOME MEASURES: The primary outcome was feasibility, defined by percentage of patients successfully receiving the intervention. Secondary outcomes included safety, defined by hospital readmission and emergency department presentations within 16 weeks postrandomisation, and treatment satisfaction, measured using Diabetes Treatment Satisfaction Questionnaire (DTSQ). Exploratory outcomes included length of stay (LOS) and change in haemoglobin A1c (HbA1c) throughout the study | ||
| 520 | |a RESULTS: The intervention was deemed feasible (85% (95% CI 73% to 94%)). No difference in safety between groups was detected. No difference in change in HbA1c between groups was detected (standard care median HbA1c -1.5% (IQR -3.7% to -0.2%) vs transition team median HbA1c -1.9% (IQR -3.8% to -0.2%), p=0.83). There was a trend towards reduced LOS in the transition team group (per protocol, standard care median LOS 8 (IQR 5.5-12); transition team median LOS 6 (IQR 3-12), p=0.06). There was a significant improvement in patient satisfaction in the transition team (standard care median 10.5 (IQR 8.5-16); transition team DTSQ change version median 15 (IQR 10-17.5), p=0.047), although interpretability is limited by missing data | ||
| 520 | |a CONCLUSION: This study demonstrated that the use of a novel transition diabetes team is a feasible alternative model of care | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a diabetes | |
| 650 | 4 | |a discharge | |
| 650 | 4 | |a injectable | |
| 650 | 4 | |a inpatient | |
| 650 | 4 | |a insulin | |
| 700 | 1 | |a Ogrin, Rajna |e verfasserin |4 aut | |
| 700 | 1 | |a Arthur, Sonja |e verfasserin |4 aut | |
| 700 | 1 | |a Zhai, Cathy |e verfasserin |4 aut | |
| 700 | 1 | |a Churilov, Leonid |e verfasserin |4 aut | |
| 700 | 1 | |a Baqar, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a Zajac, Jeffrey D |e verfasserin |4 aut | |
| 700 | 1 | |a Ekinci, Elif I |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t BMJ open |d 2012 |g 9(2019), 9 vom: 20. Sept., Seite e023583 |w (DE-627)NLM215724372 |x 2044-6055 |7 nnns |
| 773 | 1 | 8 | |g volume:9 |g year:2019 |g number:9 |g day:20 |g month:09 |g pages:e023583 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1136/bmjopen-2018-023583 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 9 |j 2019 |e 9 |b 20 |c 09 |h e023583 | ||