Study to track heart patients’ transition to home care
Sunil Kripalani, M.D., M.Sc., has been awarded a $3.4 million, five-year grant from the National Heart Lung and Blood Institute, National Institutes of Health, to look at the transition from hospital to home among 3,000 cardiovascular patients.
Sunil Kripalani, M.D., M.Sc.
“This study will help us get a more complete picture of how factors such as health literacy, cognitive function and social support affect patients’ engagement in their health care and transition home, as well as their health outcomes,” said Kripalani, chief of the Section of Hospital Medicine and associate director of the Effective Health Communication Program at Vanderbilt.
In mid-September, the interdisciplinary group will start recruiting and enrolling Vanderbilt Heart & Vascular Institute patients with acute coronary syndromes. The patients will be interviewed at three intervals after they are discharged for up to 90 days.
“Patients have a lot of information to process when they return home from the hospital. A patient who has had a mild heart attack, for instance, will have medications started or changed, be asked to modify their diet and activity level, and may have additional self-care responsibilities,” said Kripalani.
The first interview will occur two to three days after discharge and will focus on how well the transition went from hospital to home. For example, patients will be asked how prepared they felt when they left the hospital, how they rate their quality of communication with their hospital providers, what issues they are having with their medications and what type of help they got from their family and friends.
“The first interview helps us better understand the immediate period after discharge and what are some of the enablers or barriers to care,” said Kripalani.
The second and third interviews, at 30 and 90 days post-discharge respectively, will focus on outcomes assessment, including quality of life measures and health care utilization.
In addition to patient interviews, the researchers will have access to the patient’s electronic medical records at VUMC and any other emergency department or hospitals that the patient may have visited for post-discharge acute care.
Even though patient interviews conclude at 90-days post-discharge, the researchers will be linked to national databases to follow patient mortality for an additional three- to four-year period.
“This study fits within Vanderbilt’s larger vision of personalized health care delivery because it will provide very detailed personal information about aspects of care from the patient’s perspective,” said Kripalani. “We will be able to unite disease specific factors with social determinants of health to see how they each, and jointly, affect outcomes.”