Impact of an educational program to reduce healthcare resources in community-acquired pneumonia: The EDUCAP randomized controlled trial

BACKGROUND: Additional healthcare visits and rehospitalizations after discharge are frequent among patients with community-acquired pneumonia (CAP) and have a major impact on healthcare costs. We aimed to determine whether the implementation of an individualized educational program for hospitalized...

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Detalhes bibliográficos
Autores: Adamuz, Jordi, Viasus, Diego, Simonetti, Antonella Francesca, Jiménez Martínez, Emilio, Molero, Lorena, González Samartino, Maribel, Castillo, Elena, Juvé Udina, Eulàlia, Alcocer, María-Jesús, Hernández, Carme, Buera, María Pilar, Roel Fernández, Asunción, Abad, Emilia, Zabalegui Yárnoz, Adelaida, Ricart, Pilar, González, Anna, Isla Pera, Ma. Pilar (María Pilar), Dorca i Sargatal, Jordi, Garcia Vidal, Carolina, Carratalà, Jordi
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2015
País:España
Recursos:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/67648
Acesso em linha:https://hdl.handle.net/2445/67648
Access Level:acceso abierto
Palavra-chave:Pneumònia
Consum d'alcohol
Educació sanitària
Malalts hospitalitzats
Pneumonia
Drinking of alcoholic beverages
Health education
Hospital patients
Descrição
Resumo:BACKGROUND: Additional healthcare visits and rehospitalizations after discharge are frequent among patients with community-acquired pneumonia (CAP) and have a major impact on healthcare costs. We aimed to determine whether the implementation of an individualized educational program for hospitalized patients with CAP would decrease subsequent healthcare visits and readmissions within 30 days of hospital discharge. METHODS: A multicenter, randomized trial was conducted from January 1, 2011 to October 31, 2014 at three hospitals in Spain. We randomly allocated immunocompetent adults patients hospitalized for CAP to receive either an individualized educational program or conventional information before discharge. The educational program included recommendations regarding fluid intake, adherence to drug therapy and preventive vaccines, knowledge and management of the disease, progressive adaptive physical activity, and counseling for alcohol and smoking cessation. The primary trial endpoint was a composite of the frequency of additional healthcare visits and rehospitalizations within 30 days of hospital discharge. Intention-to-treat analysis was performed. RESULTS: We assigned 102 patients to receive the individualized educational program and 105 to receive conventional information. The frequency of the composite primary end point was 23.5% following the individualized program and 42.9% following the conventional information (difference, -19.4%; 95% confidence interval, -6.5% to -31.2%; P = 0.003). CONCLUSIONS: The implementation of an individualized educational program for hospitalized patients with CAP was effective in reducing subsequent healthcare visits and rehospitalizations within 30 days of discharge. Such a strategy may help optimize available healthcare resources and identify post-acute care needs in patients with CAP. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN39531840.