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Addressing Inpatient Hyponatremia Through Targeted Automatic E-consults: A Pilot Randomized Trial
Timothy J Judson1, Lowell Lo2, John E Demko2
1Department of Medicine, University of California San Francisco, San Francisco, CA, USA. Timothy.judson@ucsf.edu.
Journal of General Internal Medicine
|October 22, 2024
Summary
Targeted automatic electronic consultations (TACos) for hyponatremia were feasible and acceptable, often changing patient management. Further research is needed to confirm their impact on clinical outcomes and cost-effectiveness.
Area of Science:
- Nephrology
- Internal Medicine
- Health Informatics
Background:
- Hyponatremia is a common hospital-acquired electrolyte disorder with suboptimal correction rates.
- Limited nephrologist resources hinder timely diagnosis and treatment of hyponatremia.
- Targeted automatic electronic consultations (TACos) offer a scalable model for expert nephrology guidance.
Purpose of the Study:
- To assess the feasibility and acceptability of a TACo intervention for hospitalized patients with hyponatremia.
- To evaluate the impact of TACos on hyponatremia diagnosis and management.
Main Methods:
- A single-site, parallel-group cluster randomized trial was conducted.
- Adult inpatients with hyponatremia were enrolled.
- Nephrologists provided daily TACos with diagnostic and therapeutic recommendations.
Main Results:
- 68% of intervention patients benefited from TACos, with a mean of 2.6 e-consults per patient.
- 78% of physicians reported TACos changed their management, and 83% desired continuation.
- Clinical outcomes, including hyponatremia resolution, length of stay, readmissions, and costs, were similar between groups.
Conclusions:
- Inpatient TACos for hyponatremia are feasible and acceptable to clinical teams.
- TACos frequently influenced hyponatremia diagnosis and management strategies.
- Further investigation is required to establish the clinical and cost-effectiveness of the TACo model.
Keywords:
acceptabilitye-consultsfeasibilityhyponatremiainpatientpilot trialspecialist consultationtargeted automatic e-consultationMore Related Videos
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