Readmission Prevention Pilot Trial in Diabetes Patients
| Status: | Recruiting |
|---|---|
| Conditions: | Diabetes |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 7/13/2018 |
| Start Date: | September 7, 2017 |
| End Date: | June 1, 2019 |
| Contact: | Daniel Rubin, MD, MSc |
| Email: | daniel.rubin@tuhs.temple.edu |
| Phone: | 215-707-4746 |
A Pilot Trial to Prevent Hospital Readmission of Patients With Diabetes
Post-discharge hospital utilization, i.e., readmissions within 30 days of discharge (30d
readmissions) and emergency department (ED) visits, are a high-priority quality measure and
target for cost reduction. Patients with diabetes are disproportionately over-represented in
30d readmissions, especially among racial minorities and urban populations. We have developed
and validated a tool, the Diabetes Early Readmission Risk Indicator (DERRI), to predict 30d
readmission risk among diabetes patients, which is a critical prerequisite for targeting
limited resources for reducing readmission risk to those most in need. Currently, there are
no proven interventions to reduce the risk of 30d readmission specifically among patients
with diabetes. This proposal will assess the feasibility and acceptability of a novel,
multifactorial intervention, the Diabetes Transition of Hospital Care Program (DiaTOHC),
designed to reduce post-discharge hospital utilization rates in a pilot randomized controlled
trial. The intervention will include inpatient diabetes and discharge education,
comprehensive discharge planning and coordination of care, A1c-based adjustment of diabetes
therapy, and post-discharge support. Hospitalized patients with diabetes identified as high
risk for readmission based on the DERRI will be randomized to the intervention or the control
group, which will receive usual care. Such work is highly relevant in the current era of
soaring health care costs and national health care reform.
readmissions) and emergency department (ED) visits, are a high-priority quality measure and
target for cost reduction. Patients with diabetes are disproportionately over-represented in
30d readmissions, especially among racial minorities and urban populations. We have developed
and validated a tool, the Diabetes Early Readmission Risk Indicator (DERRI), to predict 30d
readmission risk among diabetes patients, which is a critical prerequisite for targeting
limited resources for reducing readmission risk to those most in need. Currently, there are
no proven interventions to reduce the risk of 30d readmission specifically among patients
with diabetes. This proposal will assess the feasibility and acceptability of a novel,
multifactorial intervention, the Diabetes Transition of Hospital Care Program (DiaTOHC),
designed to reduce post-discharge hospital utilization rates in a pilot randomized controlled
trial. The intervention will include inpatient diabetes and discharge education,
comprehensive discharge planning and coordination of care, A1c-based adjustment of diabetes
therapy, and post-discharge support. Hospitalized patients with diabetes identified as high
risk for readmission based on the DERRI will be randomized to the intervention or the control
group, which will receive usual care. Such work is highly relevant in the current era of
soaring health care costs and national health care reform.
Inclusion Criteria:
1. Diabetes, defined by pre-admission use of a diabetes-specific medication and/or
documentation of the diagnosis in the medical record.
Exclusion Criteria:
1. Age < 18 years at the time of admission
2. Female subjects who are pregnant and/or admitted to an obstetric service
3. Current or expected admission to a critical care unit
4. Binge drinking (5 or more alcoholic drinks for males or 4 or more alcoholic drinks for
females on the same day) or drug abuse within 3 months before admission
5. Inpatient death
6. Transfer to another hospital or subacute facility
7. Discharge to hospice or a long-term care facility
8. Discharge expected within 12 hours or admission to a short-stay unit
9. Lack of access to a phone
10. Living more than 30 miles away from Temple University Hospital (TUH)
11. Mental condition rendering the subject unable to understand the nature, scope, and
possible consequences of the study
We found this trial at
1
site
3401 N Broad St
Philadelphia, Pennsylvania
Philadelphia, Pennsylvania
(215) 707-2000
Phone: 215-707-4746
Temple University Hospital On January 18, 1892 a three-story house at 3403 North Broad Street...
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