Loading...
A family nurse-led intervention for reducing health services’ utilization in individuals with chronic diseases : The ADVICE pilot study
Savini, Serenella Iovino, Paolo Monaco, Dario Marchini, Roberta Di Giovanni, Tiziana Donato, Giuseppe Pulimeno, Ausilia Matera, Carmela Quintavalle, Giuseppe Turci, Carlo
Savini, Serenella
Iovino, Paolo
Monaco, Dario
Marchini, Roberta
Di Giovanni, Tiziana
Donato, Giuseppe
Pulimeno, Ausilia
Matera, Carmela
Quintavalle, Giuseppe
Turci, Carlo
Abstract
Objectives
Intensive health services’ utilization is common in older individuals affected by chronic diseases. This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services’ use (readmissions and/or emergency service access) among older people affected by chronic conditions.
Methods
This is a non-randomized before-after pilot study. A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 months. Standard home care was provided during the first four months’ period (months 1–4), followed by the educational intervention until the end of the study (months 5–8). The intervention, based on the teach-back method, consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment, potential complications, medication adherence, and health behaviours. Rates of health services’ use were collected immediately before (T0), and after the interventions (T1). Differences in utilization rates were examined by the McNemar’s test. Potential factors associated with the risk of health services’ use were explored with a Cox proportional hazard regression model.
Results
The sample (n = 78) was predominantly female (n = 50, 64.1%), and had a mean age of 76.2 (SD = 4.8) years. Diabetes mellitus was the most frequent disease (n = 27, 34.6%). McNemar’s test indicated a significant reduction in health services’ use at T1 (McNemar χ2 = 28.03, P < 0.001). Cox regressions indicated that time and patient education, as well as their interaction, were the only variables positively associated with the probability of health services’ use.
Conclusion
A teach-back intervention led by a family nurse practitioner has the potential to reduce health services’ use in older patients with chronic diseases.
Keywords
aged, chronic disease, facilities and services utilization, family nurse practitioners, patient readmission, home care services, health services
Date
2021
Type
Journal article
Journal
International Journal of Nursing Sciences
Book
Volume
8
Issue
3
Page Range
264-270
Article Number
ACU Department
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY-NC-ND 4.0
File Access
Open