Unmet Nonmedication Needs After Hospital Discharge and Adverse Outcomes Among Acute Respiratory Failure Survivors in Brazil: A Prospective Feasibility Study

Unmet Nonmedication Needs After Hospital Discharge and Adverse Outcomes Among Acute Respiratory Failure Survivors in Brazil: A Prospective Feasibility Study

IMPORTANCE:. In-hospital survivorship for acute respiratory failure has improved, but unmet nonmedication healthcare needs may contribute to adverse events post-discharge. OBJECTIVES:. To evaluate the feasibility of characterizing early unmet nonmedication discharge needs, classified as durable medi...

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Main Authors: Sérgio R. R. Decker, MD, MSc, Danielle do A. Pereira, BSc, Gabriela S. Rech, MSc, Rosa da R. M. dos Santos, MSc, Denise de Souza, MSc, Raíne F. De Carli, PhD, Geraldine Trott, PhD, Ana P. de Souza, PhD, Janine Gonzaga, BSc, Lauren S. Costa, MSc, Jonas M. Wolf, PhD, Gregory S. Medeiros, MD, PhD, Bruna Conte, MD, Laura C. Madeira, MD, PhD, Livia Biason, MD, MSc, Maria D. Rosa, MD, MSc, Mariana F. Mattioni, MD, MSc, Isabela T. Muller, MD, Carolia Bayer, MD, Odanor F. T. Filho, MD, Marcelo Kern, MD, MSc, Cassiano Teixeira, MD, PhD, Harris L. Carmichael, MD, MSHP, FACP, Victor D. Dinglas, MPH, Samuel M. Brown, MD, MS, Dale M. Needham, MD, PhD, Regis G. Rosa, MD, PhD
Format: Article
Language:English
Published: Wolters Kluwer 2025-07-01
Series:Critical Care Explorations
Online Access:http://journals.lww.com/10.1097/CCE.0000000000001279
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Summary:IMPORTANCE:. In-hospital survivorship for acute respiratory failure has improved, but unmet nonmedication healthcare needs may contribute to adverse events post-discharge. OBJECTIVES:. To evaluate the feasibility of characterizing early unmet nonmedication discharge needs, classified as durable medical equipment (DME), home health services (HHS), and follow-up medical appointments (FUA) for acute respiratory failure survivors in Brazil. Secondary objectives include describing the profile of needs, unmet needs, and adverse outcomes post-discharge. DESIGN:. Prospective feasibility cohort study, with enrollment between October 2020 and March 2021. SETTING:. One tertiary teaching hospital from Southern Brazil with 76 ICU beds. PARTICIPANTS:. Adult survivors from acute respiratory failure who were discharged home. MAIN OUTCOMES AND MEASURES:. Our primary outcome was the feasibility of measuring unmet nonmedication needs between 7 and 28 days post-discharge, considering greater than 80% of data completeness as feasible. Secondary outcomes included the characterization of needs and needs unmet per type at 1 month and the crude risk of all-cause death, hospital readmission, and urgent visits to the emergency department at 3 months post-discharge. RESULTS:. Of 337 patients screened, 72 were enrolled, and data on unmet nonmedication needs were collected from 66 patients, resulting in a primary feasibility outcome of 91.7%. The median age was 59 years, 38.9% were female, most were self-declared White, and were employed before admission. During the index admission, 87.3% were diagnosed with COVID-19, and 79.2% received invasive mechanical ventilation. The frequency of nonmedication discharge needs was 48 (72.7%) for DME, 54 (81.8%) for HHS, and 60 (90.9%) for FUA. At 1 month, 36 (58.1%) had at least one need unmet; at 3 months, 12 (19.0%) had at least one adverse outcome. CONCLUSIONS AND RELEVANCE:. Detailed measurement of nonmedication needs post-discharge for acute respiratory failure survivors in Brazil is feasible. Unmet nonmedication needs are a common problem to be addressed in this population.
ISSN:2639-8028

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