A family nurse-led intervention for reducing health services’ utilization in individuals with chronic diseases: The ADVICE pilot study
Objectives: Intensive health services’ utilization is common in older individuals affected by chronic diseases. This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services’ use (readmissions and/or emergency service access) among...
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doaj-0f7a64ad625c481497690c24787b99402021-07-11T04:28:05ZengElsevierInternational Journal of Nursing Sciences2352-01322021-07-0183264270A family nurse-led intervention for reducing health services’ utilization in individuals with chronic diseases: The ADVICE pilot studySerenella Savini0Paolo Iovino1Dario Monaco2Roberta Marchini3Tiziana Di Giovanni4Giuseppe Donato5Ausilia Pulimeno6Carmela Matera7Giuseppe Quintavalle8Carlo Turci9ASL Rome 4, Rome, ItalyDepartment of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; School of Nursing, Midwifery and paramedicine Faculty of health sciences, Australian Catholic University, Melbourne, AustraliaASL Rome 4, Rome, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Corresponding author. ASL Rome 4, Rome, Italy.ASL Rome 4, Rome, ItalyASL Rome 4, Rome, ItalyASL Rome 4, Rome, ItalyPresidente Ordine Professioni Infermieristiche, Rome, ItalyASL Rome 4, Rome, ItalyASL Rome 4, Rome, ItalyASL Rome 4, Rome, ItalyObjectives: Intensive health services’ utilization is common in older individuals affected by chronic diseases. This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services’ use (readmissions and/or emergency service access) among older people affected by chronic conditions. Methods: This is a non-randomized before-after pilot study. A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 months. Standard home care was provided during the first four months’ period (months 1–4), followed by the educational intervention until the end of the study (months 5–8). The intervention, based on the teach-back method, consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment, potential complications, medication adherence, and health behaviours. Rates of health services’ use were collected immediately before (T0), and after the interventions (T1). Differences in utilization rates were examined by the McNemar’s test. Potential factors associated with the risk of health services’ use were explored with a Cox proportional hazard regression model. Results: The sample (n = 78) was predominantly female (n = 50, 64.1%), and had a mean age of 76.2 (SD = 4.8) years. Diabetes mellitus was the most frequent disease (n = 27, 34.6%). McNemar’s test indicated a significant reduction in health services’ use at T1 (McNemar χ2 = 28.03, P < 0.001). Cox regressions indicated that time and patient education, as well as their interaction, were the only variables positively associated with the probability of health services’ use. Conclusion: A teach-back intervention led by a family nurse practitioner has the potential to reduce health services’ use in older patients with chronic diseases.http://www.sciencedirect.com/science/article/pii/S2352013221000533AgedChronic diseaseFacilities and services utilizationFamily nurse practitionersPatient readmissionHome care services |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Serenella Savini Paolo Iovino Dario Monaco Roberta Marchini Tiziana Di Giovanni Giuseppe Donato Ausilia Pulimeno Carmela Matera Giuseppe Quintavalle Carlo Turci |
spellingShingle |
Serenella Savini Paolo Iovino Dario Monaco Roberta Marchini Tiziana Di Giovanni Giuseppe Donato Ausilia Pulimeno Carmela Matera Giuseppe Quintavalle Carlo Turci A family nurse-led intervention for reducing health services’ utilization in individuals with chronic diseases: The ADVICE pilot study International Journal of Nursing Sciences Aged Chronic disease Facilities and services utilization Family nurse practitioners Patient readmission Home care services |
author_facet |
Serenella Savini Paolo Iovino Dario Monaco Roberta Marchini Tiziana Di Giovanni Giuseppe Donato Ausilia Pulimeno Carmela Matera Giuseppe Quintavalle Carlo Turci |
author_sort |
Serenella Savini |
title |
A family nurse-led intervention for reducing health services’ utilization in individuals with chronic diseases: The ADVICE pilot study |
title_short |
A family nurse-led intervention for reducing health services’ utilization in individuals with chronic diseases: The ADVICE pilot study |
title_full |
A family nurse-led intervention for reducing health services’ utilization in individuals with chronic diseases: The ADVICE pilot study |
title_fullStr |
A family nurse-led intervention for reducing health services’ utilization in individuals with chronic diseases: The ADVICE pilot study |
title_full_unstemmed |
A family nurse-led intervention for reducing health services’ utilization in individuals with chronic diseases: The ADVICE pilot study |
title_sort |
family nurse-led intervention for reducing health services’ utilization in individuals with chronic diseases: the advice pilot study |
publisher |
Elsevier |
series |
International Journal of Nursing Sciences |
issn |
2352-0132 |
publishDate |
2021-07-01 |
description |
Objectives: Intensive health services’ utilization is common in older individuals affected by chronic diseases. This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services’ use (readmissions and/or emergency service access) among older people affected by chronic conditions. Methods: This is a non-randomized before-after pilot study. A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 months. Standard home care was provided during the first four months’ period (months 1–4), followed by the educational intervention until the end of the study (months 5–8). The intervention, based on the teach-back method, consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment, potential complications, medication adherence, and health behaviours. Rates of health services’ use were collected immediately before (T0), and after the interventions (T1). Differences in utilization rates were examined by the McNemar’s test. Potential factors associated with the risk of health services’ use were explored with a Cox proportional hazard regression model. Results: The sample (n = 78) was predominantly female (n = 50, 64.1%), and had a mean age of 76.2 (SD = 4.8) years. Diabetes mellitus was the most frequent disease (n = 27, 34.6%). McNemar’s test indicated a significant reduction in health services’ use at T1 (McNemar χ2 = 28.03, P < 0.001). Cox regressions indicated that time and patient education, as well as their interaction, were the only variables positively associated with the probability of health services’ use. Conclusion: A teach-back intervention led by a family nurse practitioner has the potential to reduce health services’ use in older patients with chronic diseases. |
topic |
Aged Chronic disease Facilities and services utilization Family nurse practitioners Patient readmission Home care services |
url |
http://www.sciencedirect.com/science/article/pii/S2352013221000533 |
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