Initiating injectable therapy in hospital versus the home:  experiences of people with type 2 diabetes and diabetes team providing care — ASN Events
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Initiating injectable therapy in hospital versus the home:  experiences of people with type 2 diabetes and diabetes team providing care (#389)

Rajna Ogrin 1 , Felicity Pyrlis 2 , Biyun Zhai 3 , Sara Baqar 2 , Victoria Stevenson 2 , Michele Mack 2 , Jeffrey D Zajac 2 , Elif I. Ekinci 2
  1. Royal District Nursing Service, St. Kilda, VIC, Australia
  2. Endocrinology, Austin Health, Heidelberg, Victoria, Australia
  3. Medicine, University of Melbourne, Melbourne, Victoria, Australia

Context and aims:

Many people are admitted into hospital with poorly managed diabetes, requiring insulin initiation to improve health outcomes. This presentation explores the experiences of participants with type 2 diabetes receiving diabetes education as inpatients and those who received education in the home post discharge by a Transition Diabetes Team (TDT, Credentialled Diabetes Educator (CDE) and endocrinologist). 

 

Methods:

47 inpatients who were randomised to the TDT, received diabetes education by the CDE within 48 hours of discharge, and reviewed at 4 and 16 weeks of discharge in endocrinology outpatient clinic.  Four participants had their 4 months review via telehealth joint appointments with the TDT. 56 who were randomised to usual care participants received inpatient CDE and follow up according to the treating team’s discretion. Interviews were undertaken at 16 weeks post discharge, to identify the experiences of the participants.   

 

Findings:

10 interviews were undertaken with 8 participants with type 2 diabetes (4 TDT, 4 usual care), and 2 healthcare providers (average duration: 20.5 ± 6.0 minutes).  The following three themes emerged:

  1. For participants with diabetes: a. Individual characteristics; b. Emotional needs; c. Information absorption as inpatient; and d. Practicalities of initiating injectable therapy;
  2. For participants randomised to usual care: a. Prioritising injectable initiation; b. Education delivery; c. Ward staff support; and d. External support post discharge.
  3. For participants randomised to TDT and health providers: a. Emotional; b. Practical and c. Technical aspects of care.

 

Innovative contribution to practice:

Inpatients with type 2 diabetes who initiate injectable therapy while in hospital find absorbing diabetes education challenging, despite supportive ward staff.  Having education provided at home after discharge is convenient, individuals stated feeling more comfortable and had more time learning.  Health providers felt both an educator and endocrinologist working together is very convenient, finding the professional support positive.

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