RT Journal Article
SR Electronic
T1 Digital health and inpatient palliative care: a cohort-controlled study
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP e545
OP e548
DO 10.1136/spcare-2023-004474
VO 14
IS e1
A1 Singh, Baldev Malkit
A1 Kumari-Dewat, Nisha
A1 Ryder, Adam
A1 Parry, Emma
A1 Klaire, Vijay
A1 Matthews, Dawn
A1 Bennion, Gemma
A1 Jennens, Hannah
A1 Ritzenthaler, Benoit M E
A1 Rayner, Sophie
A1 Shears, Jean
A1 Ahmed, Kamran
A1 Sidhu, Mona
A1 Viswanath, Ananth
A1 Warren, Kate
YR 2024
UL http://spcare.bmj.com/content/14/e1/e545.abstract
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.