The Department of Health and Human Services funded a six-month new position, Advanced Practice Physiotherapy for in-patients with Diabetes, at the Royal Melbourne Hospital (RMH) in Melbourne, Australia. This was following a RMH audit showing increased length of stay and readmission rates for in-patients with diabetes.
To establish the feasibility of a specialised physiotherapy position in diabetes, and impact on patient outcomes (length of stay, and readmission rates).
Prospective case series. Patients were included if they were: inpatients with a primary or secondary diagnosis of diabetes, body mass index greater than 30kg/m2, and/or predicted to stay greater than 7 days. Patients were excluded if they refused intervention, already fulfilling Australian physical activity guidelines, were uncontactable, readmitted to hospital at six-weeks post-discharge, medically unable to exercise post-discharge, or deceased. Participants were allocated into intervention and non-intervention groups due to the large numbers of referrals. Both groups received standard Physiotherapy care, with the intervention group receiving further intervention of exercises and consultation (establishing goals of exercise, education, and problem-solving through barriers to exercise). All participants completed an International Physical Activity Questionnaire at baseline and six-weeks post-discharge, and a satisfaction survey.
During the three-month intervention period 56 patients were recruited into the intervention (N=36) and non-intervention (N=20) groups. Demographic data of groups were comparable at baseline. The intervention group had a median length of stay of 4.5 days less, and readmission rate 11% lower than the non-intervention group. At six-weeks post-discharge, participants in the intervention group were participating in an average of 62 minutes more moderate exercise per week.
This study demonstrated feasibility of the position, as well as demonstrating benefits on length of stay and readmission rates. Intervention participants completed more exercise at follow-up, which has wider benefits for patients and health providers in the area.