Leaflet intervention may reduce repeat ambulance callouts for hypoglycemia
medwireNews: Ambulance crews may be able to reduce the likelihood for repeat callouts to people with severe hypoglycemia by offering them advice and a leaflet on avoiding a second episode, a study suggests.
For the study, ambulance personnel from three UK regional services called out to 4825 patients with severe hypoglycemia delivered advice on how to avoid a repeat episode to 66.2% of these people, and left them with a leaflet titled “Hypos can strike twice.”
“The intervention can be of great value for ambulance services, especially due to its low cost, the cost being estimated at only £3.70 [US$ 5.11; € 4.30] per administration of which £3.60 [$ 4.56; € 4.19] are due to extra staff time and £0.10 [$ 0.14; € 0.12] to the production of the leaflet,” comment the researchers in Diabetic Medicine.
The study participants were aged between 16 and 104 years, and 54.8% were men. Age had no effect on the likelihood of the participants requiring a repeat ambulance attendance for hypoglycemia, but men were 19% more likely than women to need a second callout, and greater deprivation was also associated with an increased risk.
Delivery of the study intervention was associated with a highly significant reduction in the likelihood of a repeat ambulance attendance, although the absolute size of the effect was small, at around 5 to 10 percentage points.
Specifically, the proportion of attendances in the three regional services that were not followed by a repeat visit increased from 80.07% to 84.82%, 80.67% to 86.15%, and 76.81% to 86.69% before and after the intervention.
The beneficial effect of the intervention remained after accounting for deprivation, age, sex, and the month of the year, note Niroshan Siriwardena (University of Lincoln, UK) and co-researchers. It was also evident in an analysis that accounted for trends preceding the study baseline.
The team notes that the leaflet contained a section for ambulance personnel to detail the treatment given. In two of the regions, delivery of the intervention was associated with a significant increase in the proportion of patients receiving the ideal care bundle of blood glucose measurement, followed by treatment and then a repeat blood glucose measurement.
“The simplicity of the intervention means it could easily be scaled up to other services, but effects were small, suggesting that behavioural theory-informed complex interventions which include direct referrals to community pathways should be tested and evaluated further,” conclude the researchers.
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