A Cross-Sectional Survey Reporting on the Value of Patient-Centered Ostomy Programs: A Smooth Transition After Ostomy Surgery.
Laurie McNichol, Anna Markiewicz, Jimena Goldstine and 1 others
PMID 36108228WHAT IT FOUND
New ostomy patients who had repeated contacts with an industry-sponsored support program were more likely to discuss stoma care, leakage, skin irritation, product use, and suppliers than patients with a single contact.
The survey cannot show the program prevented readmissions.
Key findings
01Patients with two or more program interactions were more likely than patients with one interaction to discuss stoma care, pouch leakage, skin irritation, proper product use, accessory use, finding a supplier, and rating support helpful or very helpful.
02Respondents reported ostomy-related emergency department visits since surgery (17.1%), unplanned provider visits (24.9%), 30-day hospital readmission (8.75%), and readmission within 6 months (9.8%).
03Some patients still lacked basic ostomy information or home support: 1.7% did not know their ostomy type, 11.8% did not know whether it was temporary or permanent, 2.7% lacked health insurance, and 30.2% did not receive a home health nurse visit.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was a cross-sectional survey with no comparison group, so it cannot show that the support program caused any outcome. Participants were selected from a proprietary sponsor database and all had at least one interaction with the program, so people who did not use the program were not studied. The number analysed was much smaller than the number who responded: 297 of 1704 respondents, after 971 met inclusion criteria. Answers were self-reported, including emergency visits, provider visits, readmissions, knowledge, and home health visits, and were not verified in records. Patients also received other post-discharge supports, including home health nurse visits and sometimes an Ostomy Home Skills Kit, so the study cannot separate the contribution of any single component. The survey was developed for this study; face and content validity were expert judgments, and Cronbach alpha was 0.781, with no more rigorous psychometric evaluation. Missing data were not imputed, and response numbers differed by question. The findings describe one industry-sponsored program and may not apply to other patient support programs.
Declared interests
The evaluated program is Secure Start Services from Hollister Incorporated, and the sponsor distributed the survey. The article does not state individual author financial disclosures.
The easy way to misread this
Do not conclude that the support program alone reduced emergency visits or readmissions. Participants also received usual ostomy care, home health nurse visits, and sometimes an Ostomy Home Skills Kit, and the study cannot separate the contribution of any single component. The cross-sectional design does not allow conclusions about program efficacy.