Key result
Patient Buddy App proves feasible in discharged cirrhotic patients with 0 readmissions for hepatic encephalopathy.
Why the study?
Readmissions in cirrhosis, especially due to hepatic encephalopathy, could be reduced through patient and caregiver engagement, but feasibility of such interventions was unclear.
Does the Patient Buddy App reduce 30-day readmissions in cirrhotic inpatients?
Does the Patient Buddy App reduce 30-day readmissions in cirrhotic inpatients?
The Patient Buddy App is feasible for use by cirrhotic patients and caregivers and may help prevent HE-related readmissions through early outpatient interventions.
App alerts may avert HE readmissions in cirrhosis; hypothesis-generating and requires randomized trials before practice change.
BACKGROUND & AIMS: Readmissions are a major burden in cirrhosis. A proportion of readmissions in cirrhosis, especially because of hepatic encephalopathy (HE) could be avoided through patient and caregiver engagement. We aimed to define 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. METHODS: 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. At 30 days, total, and HE-related admissions were analysed as well as the feasibility and feedback regarding educational values. RESULTS: Forty patients and 40 caregivers were enrolled. Seventeen patients were readmitted within 30-days but none for HE. Eight potential HE-related readmissions were prevented through App-generated alerts that encouraged early outpatient interventions. Caregivers and patients were concordant in data entry but six did not complete data entries. Most respondents rated the App favourably for its educational value. CONCLUSIONS: In this proof-of-concept trial, the use of Patient Buddy is feasible in recently discharged patients with cirrhosis and their caregivers. Eight HE-related readmissions were potentially avoided after the use of the App.
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Ganapathy et al. (2017) studied cirrhosis (n=40). Patient Buddy App was evaluated on 30-day total and HE-related readmissions, feasibility, and feedback. The Patient Buddy App was feasible in recently discharged cirrhotic patients, with 17 of 40 patients readmitted within 30 days but none for hepatic encephalopathy.
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