Just-in-time evidence-based e-mail "reminders" in home health care: impact on patient outcomes. Health Serv Res 2005 Jun;40(3):865-85
Date
06/18/2005Pubmed ID
15960695Pubmed Central ID
PMC1361172DOI
10.1111/j.1475-6773.2005.00389.xScopus ID
2-s2.0-20344367771 (requires institutional sign-in at Scopus site) 62 CitationsAbstract
OBJECTIVE: To assess the impact and cost-effectiveness of two information-based provider reminder interventions designed to improve self-care management and outcomes of heart failure (HF) patients.
DATA SOURCES/STUDY SETTING: Interview and agency administrative data on 628 home care patients with a primary diagnosis of HF.
STUDY DESIGN: Patients were treated by nurses randomly assigned to usual care or one of two intervention groups. The basic intervention was an e-mail to the patient's nurse highlighting six HF-specific clinical recommendations. The augmented intervention supplemented the initial nurse reminder with additional clinician and patient resources.
DATA COLLECTION: Patient interviews were conducted 45 days post admission to measure self-management behaviors, HF-specific outcomes (Kansas City Cardiomyopathy Questionnaire-KCCQ), health-related quality of life (EuroQoL), and service use.
PRINCIPAL FINDINGS: Both interventions improved the mean KCCQ summary score (15.3 and 12.9 percent, respectively) relative to usual care (p< or =.05). The basic intervention also yielded a higher EuroQoL score relative to usual care (p< or =.05). In addition, the interventions had a positive impact on medication knowledge, diet, and weight monitoring. The basic intervention was more cost-effective than the augmented intervention in improving clinical outcomes.
CONCLUSIONS: This study demonstrates the positive impact of targeting evidence-based computer reminders to home health nurses to improve patient self-care behaviors, knowledge, and clinical outcomes. It also advances the field's limited understanding of the cost-effectiveness of selected strategies for translating research into practice.
Author List
Feldman PH, Murtaugh CM, Pezzin LE, McDonald MV, Peng TRAuthor
Liliana Pezzin PhD, JD Professor in the Institute for Health and Equity department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Community Health Nursing
Diffusion of Innovation
Disease Management
Electronic Mail
Evidence-Based Medicine
Female
Health Knowledge, Attitudes, Practice
Heart Failure
Home Care Services
Humans
Male
Middle Aged
Patient Education as Topic
Practice Guidelines as Topic
Reminder Systems
Self Care
United States
