Readmissions are a major burden in cirrhosis.
A proportion of readmissions in cirrhosis, especially because of hepatic encephalopathy could be avoided through patient and caregiver engagement.
Dr Dinesh Ganapathy and colleagues defined the feasibility of using the Patient Buddy App, and its impact on 30-day readmissions by engaging and educating cirrhotic inpatients and caregivers in a pilot study.
Cirrhotic inpatients with caregivers were enrolled and followed for 30 days post-discharge.
On separately assigned devices loaded with Patient Buddy, they were trained on entering medication adherence, daily sodium intake and weights, and weekly cognitive (EncephalApp_Stroop) and fall-risk assessment and were educated regarding cirrhosis-related symptoms.
These were monitored daily through a Patient Buddy loaded iPad by the clinical team.
The App sent automatic alerts between patient/caregivers and clinical team regarding adherence and critical values.
|Most respondents rated the App favorably for its educational value|
At 30 days, the team analyzed hepatic encephalopathy-related admissions as well as the feasibility and feedback regarding educational values.
The researchers enrolled 40 patients and 40 caregivers.
The research team found that 17 patients were readmitted within 30-days but none for hepatic encephalopathy.
The researchers observed that 8 potential hepatic encephalopathy-related readmissions were prevented through App-generated alerts that encouraged early outpatient interventions.
Caregivers and patients were concordant in data entry but 6 did not complete data entries.
The team found that most respondents rated the App favorably for its educational value.
Dr Ganapathy's team comments, "In this proof-of-concept trial, the use of Patient Buddy is feasible in recently discharged patients with cirrhosis and their caregivers."
"Eight hepatic encephalopathy-related readmissions were potentially avoided after the use of the App."