Diabetes, multimorbidity linked to difficult hospital-to-home transition

In the short-term postdischarge period in hospitalized older adults, diabetes complicated the transition from hospital to home and multimorbidity delayed home recovery, according to recent findings.

Researchers evaluated 96 hospitalized adults aged at least 65 years who were diagnosed with diabetes before hospitalization. Participants were hospitalized for a minimum of 48 hours and were slated to be discharged to their homes within 4 hours of enrollment.

The researchers collected general demographic data and Charlson comorbidity index data through review of medical records and charts. Participants also were interviewed regarding diabetes history, perception of readiness for discharge, hospitalization and expected home support after discharge. Transition outcomes were measured using reports of unexpected patient encounters, and home recovery was assessed through patient self-report of transition quality and measures of postdischarge coping problems.

The researchers found that 75% of the participants had multimorbidity. Chronic complication patterns were not found to be associated with variables representing participant-reported transition problems. Ninety-eight percent of participants had type 2 diabetes, which had a significant effect on multimorbidity; 46% of participants experienced three or more diabetes-related complications.

In the transition to home care, 44.9% of participants reported difficulty managing medications, 39.7% reported difficulty controlling diabetes and 54.9% reported difficulty managing a nondiabetes health problem.

Unplanned patient encounters were significantly associated with higher scores on the postdischarge coping difficulty scale at 7 and 30 days after discharge.

“The findings of this study suggest that sequential screening for the presence of postdischarge coping difficulties and early interventions for emerging transition problems may be beneficial to hospitalized older adults who have a diagnosis of diabetes, even when there is a recent history of adequate glycemic control,” the researchers wrote. – by Jennifer Byrne

The researchers report no relevant financial disclosures.

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