Developing an intervention to optimise the outcome of cardiac surgery in people with diabetes: the OCTOPuS pilot study.
Cardiothoracic surgery
Diabetes
HbA1c
In-patient
Service provision
Surgical outcomes
Journal
Pilot and feasibility studies
ISSN: 2055-5784
Titre abrégé: Pilot Feasibility Stud
Pays: England
ID NLM: 101676536
Informations de publication
Date de publication:
17 Aug 2021
17 Aug 2021
Historique:
received:
20
10
2020
accepted:
09
07
2021
entrez:
18
8
2021
pubmed:
19
8
2021
medline:
19
8
2021
Statut:
epublish
Résumé
Cardiothoracic surgical outcomes are poorer in people with diabetes compared with those without diabetes. There are two important uncertainties in the management of people with diabetes undergoing major surgery: (1) how to improve diabetes management in the weeks leading up to an elective procedure and (2) whether that improved management leads to improved postoperative outcomes. The aim of this study was to develop and pilot a specialist diabetes team-led intervention to improve surgical outcomes in people with diabetes. Open pilot feasibility study SETTING: Diabetes and cardiothoracic surgery departments, University Hospital Southampton NHS Foundation Trust PARTICIPANTS: Seventeen people with diabetes undergoing cardiothoracic surgery INTERVENTION: Following two rapid literature reviews, a prototype intervention was developed based on a previously used nurse-led outpatient intervention and tested. Feasibility and acceptability of delivering the intervention SECONDARY OUTCOMES: Biomedical data were collected at baseline and prior to surgery. We assessed how the intervention was used. In depth qualitative interviews with participants and healthcare professionals were used to explore perceptions and experiences of the intervention and how it might be improved. Thirteen of the 17 people recruited completed the study and underwent cardiothoracic surgery. All components of the OCTOPuS intervention were used, but not all parts were used for all participants. Minor changes were made to the intervention as a result of feedback from the participants and healthcare professionals. Median (IQR) HbA This study has shown that it is possible to develop a clinical pathway to improve diabetes management prior to admission. The clinical and cost-effectiveness of this intervention will now be tested in a multicentre randomised controlled trial in cardiothoracic centres across the UK. ISRCTN; ISRCTN10170306 . Registered 10 May 2018.
Sections du résumé
BACKGROUND
BACKGROUND
Cardiothoracic surgical outcomes are poorer in people with diabetes compared with those without diabetes. There are two important uncertainties in the management of people with diabetes undergoing major surgery: (1) how to improve diabetes management in the weeks leading up to an elective procedure and (2) whether that improved management leads to improved postoperative outcomes. The aim of this study was to develop and pilot a specialist diabetes team-led intervention to improve surgical outcomes in people with diabetes.
DESIGN
METHODS
Open pilot feasibility study SETTING: Diabetes and cardiothoracic surgery departments, University Hospital Southampton NHS Foundation Trust PARTICIPANTS: Seventeen people with diabetes undergoing cardiothoracic surgery INTERVENTION: Following two rapid literature reviews, a prototype intervention was developed based on a previously used nurse-led outpatient intervention and tested.
PRIMARY OUTCOME
METHODS
Feasibility and acceptability of delivering the intervention SECONDARY OUTCOMES: Biomedical data were collected at baseline and prior to surgery. We assessed how the intervention was used. In depth qualitative interviews with participants and healthcare professionals were used to explore perceptions and experiences of the intervention and how it might be improved.
RESULTS
RESULTS
Thirteen of the 17 people recruited completed the study and underwent cardiothoracic surgery. All components of the OCTOPuS intervention were used, but not all parts were used for all participants. Minor changes were made to the intervention as a result of feedback from the participants and healthcare professionals. Median (IQR) HbA
CONCLUSION
CONCLUSIONS
This study has shown that it is possible to develop a clinical pathway to improve diabetes management prior to admission. The clinical and cost-effectiveness of this intervention will now be tested in a multicentre randomised controlled trial in cardiothoracic centres across the UK.
TRIAL REGISTRATION
BACKGROUND
ISRCTN; ISRCTN10170306 . Registered 10 May 2018.
Identifiants
pubmed: 34404479
doi: 10.1186/s40814-021-00887-z
pii: 10.1186/s40814-021-00887-z
pmc: PMC8368047
doi:
Types de publication
Journal Article
Langues
eng
Pagination
157Subventions
Organisme : Health Technology Assessment Programme
ID : 16/25/12
Investigateurs
Theodore Velissaris
(T)
Paula Johnson
(P)
Rita Trodden
(R)
Mark Green
(M)
Jana Rojkova
(J)
Thea Sass
(T)
Jo Stanley
(J)
Alexandra Collier
(A)
Susi Renz
(S)
Jess Boxall
(J)
Josh Northey
(J)
Louise Stanton
(L)
Amy Whitehead
(A)
Ketan Dhatariya
(K)
Debbie Stanisstreet
(D)
Kamran Baig
(K)
Merryn Voysey
(M)
Donna Drinkwater
(D)
Joanne Lord
(J)
Jonathan Shepherd
(J)
Informations de copyright
© 2021. The Author(s).
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