Inpatient Unit Heart Failure Discharge Volume Predicts All-cause 30-Day Hospital Readmission

A cross-sectional study of factors predicting readmission in Thais with coronary artery disease

BACKGROUND

Coronary artery disease is a major cause of morbidity and mortality with high readmission rates. Hospital readmissions for coronary artery disease contribute to rising healthcare costs and are a marker of quality of care. Despite this, prior studies have found that readmission rates vary widely.

AIMS

This study aims to determine the impact of social support, depression, comorbidities, symptom severity, quality of life and readmission among coronary artery disease patients in Thailand.

METHODS

A total of 321 coronary artery disease patients from tertiary care hospitals across all regions of Thailand were recruited for this study. Data were analysed using multiple regression analysis.

RESULTS

The coefficient for social support (beta = -0.22) was found to be significant (p < 0.05), whereas comorbidity, symptom severity, depression and quality of life were not significant. Thus, social support was found to be the most significant predictive factor for readmission.

CONCLUSIONS

Accordingly, when designing effective nursing interventions, nurses should promote social support interventions for coronary artery disease patients to improve the quality of care, decrease readmission rates and improve patients' quality of life.

The Utility of CardioMEMS, a Wireless Hemodynamic Monitoring System in Reducing Heart Failure Related Hospital Readmissions

The purpose of this article is to inform nurse practitioners and other healthcare professionals regarding the utilization of CardioMEMs, a wireless pulmonary artery pressure monitoring device, in reducing heart failure-related hospital readmission rates. This article will briefly explain how CardioMEMs also helps to reduce the risk of Covid-19 in patients with heart failure.

Pharmacist-led heart failure patient focus group using mobile apps-based intervention mix

Objectives

The impact of clinical pharmacists on inpatient heart failure (HF) care has been proven in many studies. Evidence regarding the use of mobile apps by pharmacists to achieve positive clinical outcomes in HF is limited. The purpose of this study is to examine the impact of a pharmacist-led HF patient focus group using mobile apps-based intervention mix.

Methods

In this pre–post-exploratory study, using an intervention mix of hospital discharge counselling, MyTherapy app, WhatsApp and occasional phone calls to improve clinical outcomes in HF. Patient medication adherence, health-related quality of life (HRQoL) and 30-day all-cause hospital readmission rate were assessed. The Wilcoxon Signed-Rank Test was used to find statistical significance of improvements in medication adherence and HRQoL using SPSS software version 26.

Key findings

The intervention mix of initial hospital-discharge counselling, MyTherapy app, follow-up with the WhatsApp group and occasional phone calls established an effective communication with patients. All 10 patients had improvements in their clinical outcomes. Significant improvements in medication adherence and HRQoL were found (Z-value −2.810 and Z-value −2.805, respectively; 95% confidence interval). No patients were readmitted in 30 days or within 3 months of study.

Conclusions

A pharmacist-led HF patient focus group using mobile apps-based intervention mix was found to be effective in improving clinical outcomes in HF patients. Further research should be performed on long-term effects of our approach.