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Challenges in recruiting subjects to a pilot trial of patient-managed in-hospital insulin.

Acton EK, Leonard CE, Schutta MH, Cardillo S, Troxel AB, Trotta R, Hennessy S - BMC Res Notes (2015)

Bottom Line: The most common reason for refusal was lack of interest in self-managing insulin while acutely ill (36 %).Future studies of patient-managed in-hospital insulin should consider enrolling less acutely ill patients with longer anticipated lengths of stay.NCT02144441.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. eacton@sas.upenn.edu.

ABSTRACT

Background: To examine the feasibility of implementing clinician-supported inpatient self-managed insulin to aid in the planning of a randomized clinical trial.

Results: We conducted a proof-of-concept interventional study of inpatients with diabetes mellitus who had hospital orders for basal-bolus or sliding scale insulin. Patients meeting inclusion criteria were offered the opportunity to manage their own basal-bolus insulin with support from a diabetes nurse practitioner. Over a three-month screening period, we conducted 361 screens in 336 patients, only eleven of whom met all inclusion criteria. None of these eleven eligible patients elected to enroll. The most common reason for refusal was lack of interest in self-managing insulin while acutely ill (36 %).

Discussion: Future studies of patient-managed in-hospital insulin should consider enrolling less acutely ill patients with longer anticipated lengths of stay.

Trials registration: NCT02144441.

No MeSH data available.


Related in: MedlinePlus

Reasons for non-enrollment
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Fig1: Reasons for non-enrollment

Mentions: During the 3 months of the study, we performed 361 screenings in 336 patients with orders for basal-bolus or sliding-scale insulin. Repeat screening occurred for patients with multiple admissions. Only 15 screens (4 %) appeared eligible based on chart review. Four of these 15 screens (27 %) were interested in participating but did not meet the inclusion criteria assessed in person. The remaining eleven (73 %) did not wish to enroll. We determined that eight of the eleven subjects (73 %) who did not wish to enroll met all inclusion criteria, while the remaining three (27 %) would have required additional in-person screening to definitively determine eligibility (Fig. 1). The most common reason for declining participation (cited by four of eleven declining patients [36 %]), was lack of interest in being responsible for managing their own insulin therapy given their acute illness.


Challenges in recruiting subjects to a pilot trial of patient-managed in-hospital insulin.

Acton EK, Leonard CE, Schutta MH, Cardillo S, Troxel AB, Trotta R, Hennessy S - BMC Res Notes (2015)

Reasons for non-enrollment
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4590692&req=5

Fig1: Reasons for non-enrollment
Mentions: During the 3 months of the study, we performed 361 screenings in 336 patients with orders for basal-bolus or sliding-scale insulin. Repeat screening occurred for patients with multiple admissions. Only 15 screens (4 %) appeared eligible based on chart review. Four of these 15 screens (27 %) were interested in participating but did not meet the inclusion criteria assessed in person. The remaining eleven (73 %) did not wish to enroll. We determined that eight of the eleven subjects (73 %) who did not wish to enroll met all inclusion criteria, while the remaining three (27 %) would have required additional in-person screening to definitively determine eligibility (Fig. 1). The most common reason for declining participation (cited by four of eleven declining patients [36 %]), was lack of interest in being responsible for managing their own insulin therapy given their acute illness.

Bottom Line: The most common reason for refusal was lack of interest in self-managing insulin while acutely ill (36 %).Future studies of patient-managed in-hospital insulin should consider enrolling less acutely ill patients with longer anticipated lengths of stay.NCT02144441.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. eacton@sas.upenn.edu.

ABSTRACT

Background: To examine the feasibility of implementing clinician-supported inpatient self-managed insulin to aid in the planning of a randomized clinical trial.

Results: We conducted a proof-of-concept interventional study of inpatients with diabetes mellitus who had hospital orders for basal-bolus or sliding scale insulin. Patients meeting inclusion criteria were offered the opportunity to manage their own basal-bolus insulin with support from a diabetes nurse practitioner. Over a three-month screening period, we conducted 361 screens in 336 patients, only eleven of whom met all inclusion criteria. None of these eleven eligible patients elected to enroll. The most common reason for refusal was lack of interest in self-managing insulin while acutely ill (36 %).

Discussion: Future studies of patient-managed in-hospital insulin should consider enrolling less acutely ill patients with longer anticipated lengths of stay.

Trials registration: NCT02144441.

No MeSH data available.


Related in: MedlinePlus