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Diabetes and multimorbidity can affect transition from hospital to home care, study finds

Diabetes can complicate the transition from hospital to home care among older adults, while multimorbidity can delay home recovery, according to new research.
Researchers at the University of Central Florida College of Nursing evaluated a sample of 96 adults who were aged 65 or older. The sample was taken within four hours of the patients being discharged from hospital. All of the patients had been diagnosed with diabetes before hospitalisation and had spent a minimum of 48 hours in hospital.
The data sample included information such as general health status, diabetes status and perceived discharge readiness based on the Readiness for Hospital Discharge Scale.
Transition outcomes were measured based on unexpected patient encounters and post-discharge difficulty. This data was collected by telephone interviews conducted seven and 30 days after discharge. Home recovery was assessed through patient self-reports and measures of post-discharge coping problems.
Multiple morbidities such as difficulties managing medication and blood glucose were prevalent – 75 per cent of the patients had multimorbidity, and chronic illnesses other than diabetes were common problems.
98 per cent of the participants had type 2 diabetes, which significantly affected multimorbidity, while 46 per cent experienced three or more diabetes-related complications.
44.9 per cent reported difficulty managing medications in the transition to home care; 39.7 per cent had difficulty controlling their diabetes; and 54.9 per cent struggled managing a health problem unrelated to diabetes.
The researchers concluded: “The findings of this study suggest that sequential screening for the presence of post-discharge coping difficulties and early interventions for emerging transition problems may be beneficial to hospitalised older adults who have a diagnosis of diabetes, even when there is a recent history of adequate glycemic control.
“More intensive follow-up of older adults with diabetes during the first month following discharge is recommended.”
The findings were published in the online journal The Diabetes Educator.

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