Option Care ASPEN Study Shows Clinical Interventions in Home Nutrition Patients Reduce Readmissions, Save Costs
PHOENIX, March 21, 2019 – Clinical interventions provided by a nutrition support team can prevent hospital readmission in patients with short bowel syndrome (SBS) receiving home parenteral nutrition (PN), saving millions in costs annually, suggests a study¹ by Option Care Enterprises, Inc. (“Option Care”), the nation’s leading provider of home and alternate site infusion therapy services. The research is being presented at the American Society for Parenteral and Enteral Nutrition (ASPEN) 2019 Nutrition Science & Practice Conference and was chosen as an Abstract of Distinction.
Among SBS patients receiving home PN provided intravenously (IV), dehydration is a common cause of hospital readmission, with an average three-day length of stay. In the study, the nutrition support team — including a dietitian, nurse and pharmacist – made recommendations (interventions) to adjust the home PN volume based on the weekly monitoring of patients’ hydration status through reviewing laboratory values and conducting nutrition assessments.
“Home nutrition patients on PN with SBS need to be observed closely the first month to prevent dehydration and making appropriate adjustments to the home PN volume is essential,” said Mary Englert, MS, RD, CSO, LDN, CNSC, Area Lead, Nutrition Support Dietitian at Option Care and lead author of the study. “Every intervention decreases the likelihood of the patient being readmitted to the hospital and this study highlights the value of a nutrition team in providing clinical monitoring and nutrition support, which leads to improved patient care and significant cost savings.”
The study included 116 patients with SBS who received home PN after being discharged from the hospital. The Registered Dietitian-led nutrition support team provided ongoing evaluation by reviewing labs weekly and conducting a thorough nutrition assessment, recommending adjustments to the volume of PN when indicated for a total of 63 proactive interventions during the four-week review period. The most common reasons for home PN volume adjustments were: to meet the patient’s estimated fluid needs (56 percent); lab values reflecting dehydration (22 percent) and increased gastrointestinal output (22 percent).
Only 14 of the study patients were readmitted to the hospital within two weeks of discharge, none resulting from dehydration. Readmissions were due to: abscess/infection not related to PN (35.7 percent); line infection/replacement (21.4 percent); bowel obstruction (14.3 percent) and nausea/vomiting, feeding tube replacement, chest pain and unknown (7.1 percent each).
The researchers determined the interventions correlated to 189 hospital days prevented and $378,000 in costs saved in one month. Projected over one year that equates to 2,268 hospital days prevented and over $4.5 million in savings.
Also presented at ASPEN:
In another Option Care study² presented at ASPEN, 162 SBS patients were proactively screened for appropriate dosing before receiving teduglutide, which helps increase fluid and nutrient absorption resulting in decreased dependence on Parenteral Support. The clinical intervention resulted in recommended reductions to the prescribed dose in 64 of the patients (40 percent), half of which were based on impaired kidney function. Ensuring patients receive the appropriate dose reduces potential therapy complications including fluid overload, worsening kidney function and premature therapy discontinuation.
About Option Care
Option Care Enterprises, Inc. (Option Care) is the nation’s leading and most trusted provider of home and alternate site infusion services. Holding accreditations from industry quality organizations ACHC, PCAB, ASHP and URAC,* the company draws on nearly 40 years of clinical care experience to offer patient-centered therapy management. Option Care’s signature infusion services include the clinical management of infusion medicines, nursing support and care coordination. Option Care’s multidisciplinary team of more than 1,800 clinicians – including pharmacists, nurses and dietitians – are able to provide infusion service coverage for nearly all patients across the United States needing treatment for complex and chronic conditions. Learn more at www.OptionCare.com.
* Accreditation Commission for Health Care (ACHC), Pharmacy Compounding Accreditation Board (PCAB), American Society of Health-System Pharmacists (ASHP) and URAC
Englert M, Stodola K. Proactive Interventions by Nutrition Support Clinicians in Patients with Short Bowel Syndrome (SBS) on Home Parenteral Nutrition (HPN) Results in Decreased Hospitalizations and Improved Financial Outcomes. Abstract presented at the American Society for Parenteral and Enteral Nutrition (ASPEN) 2019 Nutrition Science & Practice Conference; March 23-26, 2019, Phoenix.
Hughey M, Corey B. Early Clinical Intervention Increases Compliance and Decreases Unnecessary Discontinuation in SBS Patients treated with Teduglutide. Abstract presented at the American Society for Parenteral and Enteral Nutrition (ASPEN) 2019 Nutrition Science & Practice Conference; March 23-26, 2019, Phoenix.