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Feasibility of using a transition diabetes team to commence injectable therapies postdischarge from a tertiary hospital: a pilot, randomised controlled trial.

Abstract：

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.

journal_name

BMJ Open

journal_title

BMJ open

authors

Pyrlis F,Ogrin R,Arthur S,Zhai C,Churilov L,Baqar S,Zajac JD,Ekinci EI

doi

10.1136/bmjopen-2018-023583

subject

Has Abstract

pub_date

2019-09-20 00:00:00

pages

e023583

issue

9

issn

2044-6055

pii

bmjopen-2018-023583

journal_volume

9

pub_type

杂志文章,随机对照试验

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