title: Impact of an Educational Program to Reduce Healthcare Resources in Community-Acquired Pneumonia: The EDUCAP Randomized Controlled Trial.
abstract: BACKGROUND
  Additional healthcare visits and rehospitalizations after discharge are frequent among patients with community-acquired pneumonia (CAP) and have a major impact on healthcare costs. We aimed to determine whether the implementation of an individualized educational program for hospitalized patients with CAP would decrease subsequent healthcare visits and readmissions within 30 days of hospital discharge.
  
  
  METHODS
  A multicenter, randomized trial was conducted from January 1, 2011 to October 31, 2014 at three hospitals in Spain. We randomly allocated immunocompetent adults patients hospitalized for CAP to receive either an individualized educational program or conventional information before discharge. The educational program included recommendations regarding fluid intake, adherence to drug therapy and preventive vaccines, knowledge and management of the disease, progressive adaptive physical activity, and counseling for alcohol and smoking cessation. The primary trial endpoint was a composite of the frequency of additional healthcare visits and rehospitalizations within 30 days of hospital discharge. Intention-to-treat analysis was performed.
  
  
  RESULTS
  We assigned 102 patients to receive the individualized educational program and 105 to receive conventional information. The frequency of the composite primary end point was 23.5% following the individualized program and 42.9% following the conventional information (difference, -19.4%; 95% confidence interval, -6.5% to -31.2%; P = 0.003).
  
  
  CONCLUSIONS
  The implementation of an individualized educational program for hospitalized patients with CAP was effective in reducing subsequent healthcare visits and rehospitalizations within 30 days of discharge. Such a strategy may help optimize available healthcare resources and identify post-acute care needs in patients with CAP.
  
  
  BACKGROUND
  Controlled-Trials.com ISRCTN39531840.
authors.affiliation: Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain; Department of Nursing, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain; School of Health Science, Blanquerna-Ramon Llull University, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Adamuz
authors.affiliation: Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain; Clinical Research and Biotechnology Groups, Faculty of Medicine, Universidad del Norte, Barranquilla, Colombia.
authors.forename: Diego
authors.initials: D
authors.lastname: Viasus
authors.affiliation: Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain.
authors.forename: Antonella
authors.initials: A
authors.lastname: Simonetti
authors.affiliation: Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain; Department of Nursing, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Jiménez-Martínez
authors.affiliation: Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain; Department of Nursing, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain.
authors.forename: Lorena
authors.initials: L
authors.lastname: Molero
authors.affiliation: Department of Nursing, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain; School of Nursing, University of Barcelona, IDIBELL, Barcelona, Spain.
authors.forename: Maribel
authors.initials: M
authors.lastname: González-Samartino
authors.affiliation: Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain; Department of Nursing, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Castillo
authors.affiliation: School of Nursing, University of Barcelona, IDIBELL, Barcelona, Spain; Institut Català de la Salut, Barcelona, Catalunya, Spain.
authors.forename: María-Eulalia
authors.initials: ME
authors.lastname: Juvé-Udina
authors.affiliation: Department of Nursing, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain.
authors.forename: María-Jesús
authors.initials: MJ
authors.lastname: Alcocer
authors.affiliation: Department of Nursing, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain.
authors.forename: Carme
authors.initials: C
authors.lastname: Hernández
authors.affiliation: Department of Nursing, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain.
authors.forename: María-Pilar
authors.initials: MP
authors.lastname: Buera
authors.affiliation: Department of Nursing, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain.
authors.forename: Asunción
authors.initials: A
authors.lastname: Roel
authors.affiliation: Department of Nursing, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain.
authors.forename: Emilia
authors.initials: E
authors.lastname: Abad
authors.affiliation: Department of Nursing, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain.
authors.forename: Adelaida
authors.initials: A
authors.lastname: Zabalegui
authors.affiliation: Department of Nursing, Hospital Universitari Arnau de Vilanova, IRBLleida, Lleida, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Ricart
authors.affiliation: Department of Nursing, Hospital Universitari Arnau de Vilanova, IRBLleida, Lleida, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Gonzalez
authors.affiliation: School of Nursing, University of Barcelona, IDIBELL, Barcelona, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Isla
authors.affiliation: Department of Respiratory Medicine, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Dorca
authors.affiliation: Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain.
authors.forename: Carolina
authors.initials: C
authors.lastname: Garcia-Vidal
authors.affiliation: Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain; Faculty of Medicine, Department of Clinical Sciences, University of Barcelona Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Carratalà
mesh_terms: D017714:Community-Acquired Infections / Q000191:economics* / Q000628:therapy; D006266:Health Education; D006295:Health Resources; D006801:Humans; D017063:Outcome Assessment, Health Care; D011014:Pneumonia / Q000191:economics* / Q000628:therapy