Ineffective transitional care programs for ensuring the continuation of care from acute settings to the home settings post discharge can result in rehospitalization of elderly patients with chronic diseases. Usually, transitional care should be time-sensitive, patient-centered services intended to ensure continuity of care and an efficient transition between health care settings or home. A patient centered transitional care program was implemented at an outpatient primary care facility to reduce readmission rates. Institutional Review Board approval was obtained.

Twenty adult patients with chronic diseases discharged from an acute setting were identified. A follow up phone call and/or a home visit within 24-72 hours post discharge was employed. The Care Transitions Measure (CTM®) and Medication Discrepancy Tool (MDT®) were utilized to identify quality of care of transition and medication discrepancies. A chart audit collected data on the age of participant, diagnosis for initial hospitalization, CTM score, home visit, and ED visits or re-hospitalizations after 30 days of discharge. The outcome indicated that transitional care within primary care utilizing evidence-based practices is beneficial in reducing readmission rates. A logistic regression showed model significance, p = .002, suggesting that the CTM score was effective for both telephone support (TS) and home visit (HV).

A correlation analysis showed that as age of participants increased, the CTM score decreased, indicating that older adults required more support. A significance p <.001, of a proportional test indicated that readmission rates after the intervention was lower. It is evident that providing a timely and effective transitional care intervention in a primary care setting can reduce hospital readmissions, improve symptom management and quality of life of adult patients with chronic diseases.

Functional GI disorders are categorized as a group of chronic symptoms that are considered to have no abnormalities that can account for patient’s illnesses. Included in this category are those patients with irritable bowel syndrome. Functional GI issues are an important public health concern as they are becoming increasingly more common; they can be disabling and can cause significant socioeconomic burden in regard to health care costs, productivity and disability. There is strong evidence that probiotics have the potential to reduce IBS symptoms. Unfortunately, probiotics are underutilized in the clinical setting.

The purpose of this project is to increase knowledge and self-efficacy in patients with functional GI symptoms regarding the use of probiotics for symptom management. Patients in an outpatient GI practice in Southwestern United States with chronic functional GI symptoms were shown an educational video regarding the origins and benefits of using probiotics to manage chronic symptoms. Knowledge of probiotics, self-efficacy and willingness to utilize probiotics was measured by asking participants to complete a modified Health Belief Model survey before and after viewing the video. Patient demographics were collected. There were 75 participants (n=75) who participated in the project with a mean age of 40.3 years (SD=15.41), 85% female and 15% male. Wilcoxon signed rank test were used to analyze changes in paired data with significant improvements in self-efficacy (Z=3.93, p< .01), benefits of probiotic use (Z=4.33, p<.01) and decreased barriers to probiotics use (Z=-4.31, p<.01). After participants viewed the educational video, 95% of patients indicated they would try probiotics (CI 95%, p<.01) versus 65% of patients who would try probiotics before viewing video. In conclusion, education regarding using probiotics to manage functional GI symptoms improved patient’s self-efficacy and their willingness to use probiotics to manage their symptoms. Keywords: probiotics, GI disorders, diarrhea, IBS, constipation, abdominal pain, self-efficacy.

INCREASED EDUCATION AND SELF-EFFICACY IN PROBIOTIC USE:
Education and Self-efficacy of Probiotic Use in Patients with Chronic Gastrointestinal Symptoms
Functional gastrointestinal (GI) disorders are categorized as a group of chronic symptoms that are considered to have no structural or biochemical abnormalities that can account for patient’s illness. Included in this category are those patients diagnosed with irritable bowel syndrome (IBS). IBS is chronic GI disorder characterized by abdominal pain accompanied by altered bowel function, gas and bloating without the presence of organic disease (Mapel, 2013). Functional gastrointestinal symptoms typically include complaints of long-standing issues (greater than 3 months) of diarrhea, abdominal pain, constipation, gas and bloating.