scholarly journals 35DETERMINANTS OF POST-DISCHARGE FALLS AND FRACTURES AFTER STROKE OVER LONG TERM FOLLOW UP

2017 ◽  
Vol 46 (suppl_2) ◽  
pp. ii11-ii13
Author(s):  
E J Foster ◽  
R S Barlas ◽  
A B Clark ◽  
J H Bettencourt-Silva ◽  
K M Bowles ◽  
...  
Keyword(s):  
Post Discharge ◽  
Long Term Follow Up

Effectiveness of a diabetes focused electronic discharge orderset and post-discharge nursing support among poorly controlled hospitalized patients: A randomized controlled trial (Preprint)

2021 ◽  
Author(s):  
Audrey White ◽  
David Bradley ◽  
Elizabeth Buschur ◽  
Cara Harris ◽  
Jacob LaFleur ◽  
...  
Keyword(s):  
Diabetes Management ◽  
Hospitalized Patients ◽  
Post Discharge ◽  
Discharge Data ◽  
Phone Calls ◽  
Discharge Outcomes ◽  
Long Term Follow Up ◽  
Order Set

BACKGROUND While electronic order sets have become standard practice for inpatient diabetes management, there is limited decision support at discharge. OBJECTIVE This study assessed whether an electronic discharge order set (DOS) plus nurse follow up calls improves discharge orders and post-discharge outcomes among hospitalized patients with type 2 diabetes (T2D). METHODS This is a randomized open label single center study comparing an electronic DOS and nurse phone calls to enhanced standard care (ESC) in hospitalized insulin-requiring patients with T2D. The primary outcome was change in HbA1c at 24 weeks post-discharge. Secondary outcomes included completeness and accuracy of discharge prescriptions related to diabetes. RESULTS The study was stopped early due to feasibility concerns related to long-term follow-up. However a total of 158 subjects were enrolled (DOS=82, ESC=76), 155 of whom had discharge data. The DOS group had a greater frequency of prescriptions for bolus insulin (81% vs 44%; P=0.01), needles/syringes (95% vs 63%; P=0.03), and glucometers (86% vs 36%; P=0.0002). Clarity of orders was similar. HbA1c was available in 27 subjects in each arm at 12 weeks, and 20/21 subjects in the DOS/ESC arms at 24 weeks. The adjusted difference in change in HbA1c (DOS-ESC) was -0.5 ± 0.4% at 12 weeks (P = 0.20) and -0.7 ± 0.4% at 24 weeks (P= 0.09). Achievement of individualized HbA1c target was greater in the DOS group at 12 weeks but not 24 weeks. CONCLUSIONS A DOS resulted in more complete discharge prescriptions. Assessment of post-discharge outcomes was limited due to loss of long-term follow-up but suggests possible benefit in glucose control. CLINICALTRIAL NCT03455985 Effectiveness of a Diabetes Focused Discharge Order Set Among Poorly Controlled Hospitalized Patients Transitioning to Glargine U300 Insulin

Abstract TP378: Long Term Follow Up Telephone Evaluation of Post Stroke Quality of Life is Feasible and Effective

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Renata Miranda ◽  
Carla Ledo ◽  
Daisa Escobosa ◽  
Caren Cristina Giannotti Bizutti ◽  
Amanda Ruiz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Data Collection ◽  
Clinical Outcomes ◽  
Stroke Recurrence ◽  
Post Discharge ◽  
Phone Calls ◽  
Long Term Follow Up

Background: The long-term follow-up of clinical outcomes in patients admitted with acute stroke can identify relevant clinical data in the prevention of stroke recurrence as well as measure the quality of life of such patients. Follow-up after discharge in hospitals without stroke clinics can be a challenge. Therefore we created in our hospital an outcomes measurement nuclei characterized as a data collection center, with the main objective of periodically measuring clinical outcomes and quality of life of patients after hospital discharge.This sector works together with the different clinical specialties in providing information with a focus on outcome indicators, using questionnaires to estimate the parameters of evaluation of health states.Our objective was to describe data obtained from this data collection center evaluating post-discharge quality of life of patients treated in our stroke center 30, 90, 180 days and 01 years after the diagnosis. Methods: The study was conducted from January 2012 to March 2016, at a tertiary, general, private hospital in São Paulo, Brazil. Phone calls using the EuroQol instrument (EQ-5D) to measure quality of life were performed. The modified Rankin scale and a structured questionnaire to identify stroke recurrence, readmissions and medication failures were also applied. Results: We conducted 2184 telephone calls and obtained 1727 (79%) successful contacts. The mean EQ-5D at 30 days was: 0.732 +/-0.558; at 90 days: 0.722 +/- 0.358; at 180 Days: 0.781 +/- 0.326; and at 12 months 0.766 +/-0.349. During the follow-up, 31 patients (2%) died. The main reasons for censuring patients were unsuccessful contact after 3 attempts (51%); outdated registration data (3%) and refusals (9%). Conclusion: In conclusion, monitoring of standardized clinical outcomes after stroke is possible even in private non academic hospitals, allowing the acquisition of quality of care indicators and patient centered outcomes.

Abstract 13907: Patients With NSTEMI Are at Higher Risk, Have Worse Outcomes, but Less Intense Cardiology Follow-up 1-3 Years Post-discharge: Findings From the TIGRIS Registry

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sibi N Krishnamurthy ◽  
Stuart Pocock ◽  
Prashant Kaul ◽  
Ruth Owen ◽  
Jiyan Chen ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Post Discharge ◽  
Relative Risks ◽  
All Cause Mortality ◽  
Long Term Follow Up ◽  
St Elevation ◽  
The Mean ◽  
Long Term Prognosis

Introduction: Non-ST-elevation myocardial infarction (NSTEMI) patients have more comorbidities and extensive CAD than STEMI patients. However, there is a need for comparative data on the long-term prognosis and resource utilization of stable patients after these MI subtypes. Methods: TIGRIS enrolled 9027 stable patients 1-3 years post-MI (369 centers, 25 countries) with ≥1 risk factor (age ≥65 years, diabetes, 2nd prior MI, multivessel CAD, CKD). The incidence of cardiovascular (CV) events and deaths, and self-reported EQ-D5 score were recorded over 2 years. Multivariable Poisson regression models were used to compare STEMI and NSTEMI patients for relative risks, adjusting for prognostically relevant patient factors. Results: MI subtype was known in 8494 patients (STEMI: 56%; NSTEMI: 44%). At enrollment, NSTEMI patients were more likely to be older, have diabetes, hypertension, hyperlipidemia, and prior CAD compared with STEMI patients. NSTEMI patients had significantly poorer self-rated health and a lower use of dual antiplatelet therapy at discharge and 1-3 years later. NSTEMI patients had a higher incidence of the composite of MI, stroke and CV death over 2 years (5.6% vs 4.0%, p<0.001) and higher all-cause mortality (4.1% vs 2.6%, p<0.001) vs STEMI patients (Figure). These excess risks for the composite outcome attenuated after adjusting for baseline characteristics (adj RR 1.18, 95% CI 0.96-1.45, p=0.11), but remained significant for all-cause mortality (adj RR 1.31, 95% CI 1.02-1.68, p=0.03). Resource utilization over 2 years was higher in NSTEMI patients, although the mean number of cardiologist visits were higher for STEMI patients (4.2 vs 2.8, p<0.001). Conclusions: NSTEMI patients had a less favorable risk profile and experienced more adverse CV events during long-term follow-up than STEMI patients, but had less intense cardiology follow-up. Continued efforts are needed to optimize secondary prevention and care of stable patients after NSTEMI.

Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

2019 ◽  
Vol 42 ◽  
Author(s):  
John P. A. Ioannidis
Keyword(s):  
Mental Health ◽  
Mental Disease ◽  
Brain Disorders ◽  
Social Stressors ◽  
Labor Education ◽  
Mental Diseases ◽  
Long Term Follow Up ◽  
Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

A comparison of two approaches to biofeedback treatment in children with recalcitrant constipation/encopresis. Long term follow up

2001 ◽  
Vol 120 (5) ◽  
pp. A397-A397
Author(s):  
M SAMERAMMAR ◽  
J CROFFIE ◽  
M PFEFFERKORN ◽  
S GUPTA ◽  
M CORKINS ◽  
...  
Keyword(s):  
Long Term Follow Up ◽  
Biofeedback Treatment

Endoscopic sphiecterotomy without cholecystectomy for prevention of recurrence of acute billary pancreatitis: Long-term follow-up of 73 patients

2001 ◽  
Vol 120 (5) ◽  
pp. A204-A204
Author(s):  
B GONZALEZCONDE ◽  
J VAZQUEZIGLESIAS ◽  
L LOPEZROSES ◽  
P ALONSOAGUIRRE ◽  
A LANCHO ◽  
...  
Keyword(s):  
Long Term Follow Up ◽  
Prevention Of Recurrence

Epidemilogical long term follow up in functional dyspepsia: Characteristics of non-responders

2001 ◽  
Vol 120 (5) ◽  
pp. A754-A755 ◽  
Author(s):  
H ALLESCHER ◽  
P ENCK ◽  
G ADLER ◽  
R DIETL ◽  
J HARTUNG ◽  
...  
Keyword(s):  
Functional Dyspepsia ◽  
Long Term Follow Up

8: Predictors of HRQOL Duirng Long-Term Follow-Up of Men Treated for Prostate Cancer

2007 ◽  
Vol 177 (4S) ◽  
pp. 3-4
Author(s):  
George J. Huang ◽  
Natalia Sadetsky ◽  
Peter R. Carroll ◽  
David F. Penson
Keyword(s):  
Prostate Cancer ◽  
Long Term Follow Up
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