The patient buddy app can potentially prevent hepatic encephalopathy‐related readmissions

• DOI: 10.1111/liv.13494
• Publication Date: 2017-06-15T11:37:50Z
• Authors: Dinesh Ganapathy; Chathur Acharya; Jatinder Lachar; Kavish Patidar; Richard K. Sterling; Melanie B. White; Catherine Ignudo; Swamy Bommidi; John DeSoto; Leroy R. Thacker; Scott Matherly; Jawaid Shaw; Mohammad S. Siddiqui; Puneet Puri; Arun J. Sanyal; Velimir Luketic; Hannah Lee; Richard T. Stravitz; Jasmohan S. Bajaj
• Keywords: Male; 0301 basic medicine; Middle Aged; Mobile Applications; Patient Readmission; Proof of Concept Study; 3. Good health; 03 medical and health sciences; Hepatic Encephalopathy; Humans; Female; Smartphone; Aged

AbstractBackground & AimsReadmissions are a major burden in cirrhosis. A proportion of readmissions in cirrhosis, especially because of hepatic encephalopathy (HE) could be avoided through patient and caregiver engagement. We aimed to define the feasibility of using the Patient Buddy App and its impact on 30‐day readmissions by engaging and educating cirrhotic inpatients and caregivers in a pilot study.MethodsCirrhotic inpatients with caregivers were enrolled and followed for 30 days post‐discharge. On separately assigned devices loaded with Patient Buddy, they were trained on entering medication adherence, daily sodium intake and weights, and weekly cognitive (EncephalApp_Stroop) and fall‐risk assessment and were educated regarding cirrhosis‐related symptoms. These were monitored daily through a Patient Buddy loaded iPad by the clinical team. The App sent automatic alerts between patient/caregivers and clinical team regarding adherence and critical values. At 30 days, total, and HE‐related admissions were analysed as well as the feasibility and feedback regarding educational values.ResultsForty patients and 40 caregivers were enrolled. Seventeen patients were readmitted within 30‐days but none for HE. Eight potential HE‐related readmissions were prevented through App‐generated alerts that encouraged early outpatient interventions. Caregivers and patients were concordant in data entry but six did not complete data entries. Most respondents rated the App favourably for its educational value.ConclusionsIn this proof‐of‐concept trial, the use of Patient Buddy is feasible in recently discharged patients with cirrhosis and their caregivers. Eight HE‐related readmissions were potentially avoided after the use of the App.