Health information technology interventions reduce avoidable readmissions in cirrhosis: The HEROIC randomized...

Area of Science:

• Hepatology
• Health Information Technology
• Patient Engagement

Background:

• Reducing avoidable readmissions in cirrhosis patients is a significant clinical challenge.
• Previous studies suggested health information technology (HIT) interventions and caregiver involvement can lower readmission rates.
• The Patient Buddy App (PBA) was developed to enhance patient engagement and support.

Purpose of the Study:

• To conduct a multicenter trial comparing the PBA intervention against standard of care (SOC) for reducing avoidable readmissions in cirrhosis inpatients.
• To evaluate the effectiveness of a health information technology (HIT) tool in managing cirrhosis patients post-discharge.

Main Methods:

• A multicenter, open-label, randomized clinical trial involving 464 cirrhosis inpatients and their adult caregivers (dyads).
• Intervention group utilized the Patient Buddy App (PBA) for medication adherence, cognitive testing, and symptom monitoring, with remote staff oversight.
• Comparison group received standard of care (SOC). Primary outcome was avoidable readmissions, assessed by a blinded monitoring board.

Main Results:

• Avoidable readmissions were significantly lower in the PBA group (10.3%) compared to the SOC group (19.8%) (p=0.04).
• All-cause readmissions were also significantly higher in the SOC group (48%) versus the PBA group (30%) (p=0.005).
• The PBA generated 1660 alerts, primarily for hepatic encephalopathy (HE), and most dyads reported satisfaction with the app.

Conclusions:

• The Patient Buddy App (PBA) intervention was associated with a significant reduction in 30-day avoidable readmissions for cirrhosis inpatients compared to standard of care.
• HIT-based interventions, like the PBA, show promise in improving clinical outcomes and managing complex chronic conditions such as cirrhosis.