• Khadijah Breathett, Scott Maffett, Randi E Foraker, Rod Sturdivant, Kristina Moon, Ayesha Hasan, Veronica Franco, Sakima Smith, Brent C Lampert, Sitaramesh Emani, Garrie Haas, Rami Kahwash, Ray E Hershberger, Philip F Binkley, Laura Helmkamp, Kathryn Colborn, Pamela N Peterson, Nancy Sweitzer, and William T Abraham.
• Division of Cardiovascular Medicine, Sarver Heart Center, University of Arizona, Tucson. Electronic address: kbreathett@shc.arizona.edu.
• Am. J. Med. 2018 Aug 1; 131 (8): 974978974-978.

BackgroundHeart failure education programs are not standardized. The best form of education is unclear. We evaluated whether addition of a novel tablet application to nurse practitioner (NP) education was superior to NP education alone in reducing 30-day readmission after heart failure hospitalization.MethodsFrom February 2015-March 2016, patients admitted to a quaternary academic center with primary diagnosis of heart failure were randomized to 1) treatment - NP education plus tablet application (interactive conditional logic program that flags patient questions to medical staff), or 2) control - NP education. The primary outcome was reduction in 30-day readmission rate. Secondary outcomes included satisfaction and education assessed via survey.ResultsRandomization included 60 patients to treatment and 66 to control. A total of 13 patients withdrew prior to intervention (treatment n = 4, control n = 1) or were lost to follow-up (treatment n = 3, control n = 5). The 30-day readmission rate trended lower for treatment compared with control, but results were not statistically significant (13.2% [7/53], 26.7% [16/60], respectively, P = .08). Similarly, satisfaction trended higher with treatment than control (P = .08). Treatment patients rated explanations from their physicians higher than control (Always: 83.7%, 55.8%, respectively, P = .01).ConclusionsNP education plus tablet use was not associated with significantly lower 30-day readmission rates in comparison with NP alone, but a positive trend was seen. Patient satisfaction trended higher and heart failure explanations were better with NP education plus tablet. A larger study is needed to determine if NP education plus tablet reduces readmission rates following heart failure admission.Copyright © 2018 Elsevier Inc. All rights reserved.

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