PT  - JOURNAL ARTICLE
AU  - Singh, Baldev Malkit
AU  - Kumari-Dewat, Nisha
AU  - Ryder, Adam
AU  - Parry, Emma
AU  - Klaire, Vijay
AU  - Matthews, Dawn
AU  - Bennion, Gemma
AU  - Jennens, Hannah
AU  - Ritzenthaler, Benoit M E
AU  - Rayner, Sophie
AU  - Shears, Jean
AU  - Ahmed, Kamran
AU  - Sidhu, Mona
AU  - Viswanath, Ananth
AU  - Warren, Kate
TI  - Digital health and inpatient palliative care: a cohort-controlled study
AID  - 10.1136/spcare-2023-004474
DP  - 2024 May 01
TA  - BMJ Supportive & Palliative Care
PG  - e545--e548
VI  - 14
IP  - e1
4099  - http://spcare.bmj.com/content/14/e1/e545.short
4100  - http://spcare.bmj.com/content/14/e1/e545.full
SO  - BMJ Support Palliat Care2024 May 01; 14
AB  - Objectives End of life has unacceptable levels of hospital admission and death. We aimed to determine the association of a novel digital specific system (Proactive Risk-Based and Data-Driven Assessment of Patients at the End of Life, PRADA) to modify such events.Methods A cohort-controlled study of those discharged alive, who died within 90 days of discharge, comparing PRADA (n=114) with standard care (n=3730).Results At 90 days, the PRADA group were more likely to die (78.9% vs 46.2%, p<0.001), had a shorter time to death (58±90 vs 178±186 days, p<0.001) but readmission (20.2% vs 37.9%, p<0.001) or death in hospital (4.4% vs 28.9%, p<0.001) was lower with reduced risk for a combined 90-day outcome of postdischarge non-elective admission or hospital death (OR 0.45, 95% CI 0.27–0.74, p<0.001). Tightening criteria with 1:1 matching (n=83 vs 83) showed persistent significant findings in PRADA contact with markedly reduced adverse events (OR 0.15, 95% CI 0.02–0.96, p<0.05).Conclusions Being seen in hospital by a specialist palliative care team using the PRADA tool was associated with significantly improved postdischarge outcomes pertaining to those destined to die after discharge.