Patient Experience after Being Discharged with Newly Prescribed Insulin or Oral Hypoglycemic Agents

Abstract

Objective: To identify issues surrounding discharge from hospitalization in patients newly prescribed insulin or oral hypoglycemic agents. Methods: We conducted telephone surveys and retrospective chart reviews on adult patients satisfying the aforementioned conditions one week after they were discharged from an academic medical center. Data gathered included glucose levels, logistical issues in obtaining medications or testing supplies, and barriers for testing and treating DM. We compared A1c during and after admission, and identified factors associated with change in A1c. Results: We attempted to contact 141 eligible patients phone, and reached 98. Of 98 patients, 85 were scheduled with a follow-up with PCP or endocrinology within 60 days of discharge, 13 patients were discharged without follow-up scheduled; 76 were discharged with enough supplies and medication to last until next follow-up. Regarding overall glucose control after discharge, 69 patients were completely to very satisfied, 18 were somewhat satisfied, 11 were slightly to not at all satisfied. Fifty patients had repeat A1c available after admission (median 116 days, IQR 92, 196). There was a significant decrease in A1c (admission mean 9.5% ± SD 2.7 vs. follow-up 7.0% ± 1.5, p <0.0001). There was no statistically significant change in percentage A1c reduction whether patient received bedside delivery (-22.3% ± 18.8) or not (-23.5% ± 22.0; p = 0.825), or between medical (-25.4% ± 20.4) and surgical services (-16.2% ± 18.7, p = 0.134). Patients utilizing bedside delivery program (pharmacy bringing discharge medications to patient’s room) were more likely to receive the correct diabetes testing supplies and medications (95.2%) than those who did not use the service (71.1%) (p=0.003). Conclusion: Most patients were satisfied with DM education and readiness upon discharge. Bedside delivery may help improve percentage of discharge with correct supplies and medications. Disclosure N.Z. Madhun: None. E. Calogeras: None. S. Niwattisaiwong: None. M. Lansang: None.