A169 PRICE: PREVENTING READMISSIONS IN IBD CENTRES OF EXCELLENCE. (21st February 2022) - Dang, F
Abstract: Background: Hospital readmission rates are high in the inflammatory bowel disease (IBD) population, with 20% of patients readmitted within the same year. Discharge processes are not routinely standardized and deficiencies in transition of care puts patients at an increased risk of recurrent illness and healthcare costs. In addition, hospitalizations for IBD patients are associated with nosocomial complications such as venous thromboembolism. Aims: We hypothesize that standardized follow-up by an IBD practice nurse and electronic health outcome monitoring reduces the risk of hospital readmission compared to current approaches of hospital discharge alone. Methods: This pilot study uses a prospective parallel randomized control design and includes patients admitted with an IBD flare who were discharged without surgical intervention. Patients randomized to the control arm were discharged with usual standard of care (i.e. discharge summary and/or follow-up). In addition to standard of care, those in the intervention group received organized telephone or email follow-up by an IBD practice nurse at 1, 7 and 30 days post-discharge. These patients also received bi-weekly corespondence from an electronic survey tool, NoviSurvey, to determine clinical disease severity and medication adherence. Based on patient interactions and survey responses, the IBD nurse may arrange for expedited ambulatory visit or readmission for high-risk patients. Results: At present, 41 patients have been enrolled into our study, 4 of which were excluded due to surgical management. 19 patients were randomized to the intervention and 17 to the control group. In the intervention group, the 30-day cumulative rate of readmission [0/19 (0%) vs. 4/17 (24%), p = 0.040] as well as the proportion of patients who failed to taper steroids [0/18 (0%) vs. 5/15 (33%), p = 0.013] was significantly lower when compared to the control group. There were no occurrences of deep vein thrombosis within 30 days post-discharge in either group. Conclusions: These findings in our pilot study indicate that a nurse led post-discharge intervention may translate to benefits including decreased readmission rates and better medication adherence, warranting a large clinical trial to confirm findings. Patient Demographics and Clinical Outcomes Between Intervention and Control Groups Funding Agencies: CAG, CCC