PROspective Assessment of hospital discharge Characteristics That may Impact post-discharge outcomes and eVents (PROACTIVE)
Patients are most commonly admitted to General Internal Medicine (GIM) for heart failure, COPD, pneumonia, urinary tract infection and delirium; up to 25% of discharged GIM patients need to be readmitted to hospital within one month. There is little knowledge regarding whether depressive symptoms and anxiety could be predictors of readmission and/or death in the first 30 and 90 days after discharge from GIM wards and whether patients exhibiting depressive symptoms after discharge are treated with medication by family physicians.
This study is a prospective cohort, contacting patients at hospital discharge, 30 and 90 days post-discharge by telephone to measure depressive symptoms, anxiety, and functionality. The primary outcome will be depression score distribution, using the Patient Health Questionnaire (PHQ-9) and analyzing for covariate-adjusted risk of readmission/post-discharge death in 30 or 90 days. The patient's pharmacy will also be contacted at both time points to obtain a current medication list, to examine patient compliance with discharge medications at 30 days and to determine if anti-depressant medications are started by family physicians for patients with positive PHQ-9 scores after discharge. PHQ-9 score distributions will also be examined against comorbidities to determine any correlations. Since recruitment began on October 9, 2013, 195 patients are enrolled and 40 have competed 90-day follow-up, with a goal of approximately 500 from the University of Alberta Hospital and The Royal Alexandra Hospital.