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nurse-coordinated cardiac care bridge transitional care programme: a randomised clinical trial.
- Source :
- Age & Ageing; Nov2021, Vol. 50 Issue 6, p2105-2115, 11p, 2 Diagrams, 3 Charts, 1 Graph
- Publication Year :
- 2021
-
Abstract
- Background after hospitalisation for cardiac disease, older patients are at high risk of readmission and death. Objective the cardiac care bridge (CCB) transitional care programme evaluated the impact of combining case management, disease management and home-based cardiac rehabilitation (CR) on hospital readmission and mortality. Design single-blind, randomised clinical trial. Setting the trial was conducted in six hospitals in the Netherlands between June 2017 and March 2020. Community-based nurses and physical therapists continued care post-discharge. Subjects cardiac patients ≥ 70 years were eligible if they were at high risk of functional loss or if they had had an unplanned hospital admission in the previous 6 months. Methods the intervention group received a comprehensive geriatric assessment-based integrated care plan, a face-to-face handover with the community nurse before discharge and follow-up home visits. The community nurse collaborated with a pharmacist and participants received home-based CR from a physical therapist. The primary composite outcome was first all-cause unplanned readmission or mortality at 6 months. Results in total, 306 participants were included. Mean age was 82.4 (standard deviation 6.3), 58% had heart failure and 92% were acutely hospitalised. 67% of the intervention key-elements were delivered. The composite outcome incidence was 54.2% (83/153) in the intervention group and 47.7% (73/153) in the control group (risk differences 6.5% [95% confidence intervals, CI −4.7 to 18%], risk ratios 1.14 [95% CI 0.91–1.42], P = 0.253). The study was discontinued prematurely due to implementation activities in usual care. Conclusion in high-risk older cardiac patients, the CCB programme did not reduce hospital readmission or mortality within 6 months. Trial registration Netherlands Trial Register 6,316, https://www.trialregister.nl/trial/6169 [ABSTRACT FROM AUTHOR]
- Subjects :
- MORTALITY risk factors
EVALUATION of medical care
HOSPITALS
PATIENT aftercare
CONFIDENCE intervals
EVALUATION of human services programs
SOCIAL services case management
HOME rehabilitation
HOME care services
AGE distribution
MEDICAL care
PATIENT readmissions
HOSPITAL health promotion programs
GERIATRIC assessment
CONTINUUM of care
HOSPITAL mortality
RANDOMIZED controlled trials
MEDICAL protocols
CARDIAC rehabilitation
NURSES
INTERPROFESSIONAL relations
BLIND experiment
HOSPITAL care
DESCRIPTIVE statistics
DISEASE management
COMMUNITY health nursing
DISCHARGE planning
EVALUATION
Subjects
Details
- Language :
- English
- ISSN :
- 00020729
- Volume :
- 50
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Age & Ageing
- Publication Type :
- Academic Journal
- Accession number :
- 153609862
- Full Text :
- https://doi.org/10.1093/ageing/afab146