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The nurse-coordinated cardiac care bridge transitional care programme: a randomised clinical trial

Authors :
Jill Dekker
Patricia Jepma
Sara Daliri
Lotte Verweij
Su-San Liem
Fatma Karapinar-Çarkit
Corine H.M. Latour
José L. Klunder
Wilma Scholte op Reimer
Bianca M. Buurman
Michel S. Terbraak
Ron J.G. Peters
Gerben ter Riet
Arno H.M. Moons
University of Zurich
Jepma, Patricia
Cardiology
VU University medical center
ACS - Atherosclerosis & ischemic syndromes
Nursing
Geriatrics
APH - Aging & Later Life
APH - Quality of Care
Pharmacy
APH - Personalized Medicine
ACS - Diabetes & metabolism
ACS - Heart failure & arrhythmias
Faculteit Gezondheid
Urban Vitality
Lectoraat Integratie van Psychiatrische en Somatische Zorg
Lectoraat Acute Ouderenzorg
Source :
Age and Ageing, 50(6), 2105-2115. Oxford University Press, Jepma, P, Verweij, L, Buurman, B M, Terbraak, M S, Daliri, S, Latour, C H M, Ter Riet, G, Karapinar-Çarkit, F, Dekker, J, Klunder, J L, Liem, S S, Moons, A H M, Peters, R J G & Scholte Op Reimer, W J M 2021, ' The nurse-coordinated cardiac care bridge transitional care programme: a randomised clinical trial ', Age and Ageing, vol. 50, no. 6, pp. 2105-2115 . https://doi.org/10.1093/ageing/afab146, Age and Ageing, 50(6), 2105-2115, Age and ageing, 50(6), 2105-2115. Oxford University Press, Age and Ageing, 50(6):afab146, 2105-2115. Oxford University Press, Age and Ageing
Publication Year :
2021
Publisher :
Oxford University Press, 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

Details

Language :
English
ISSN :
14682834, 00020729, and 21052115
Volume :
50
Issue :
6
Database :
OpenAIRE
Journal :
Age and Ageing
Accession number :
edsair.doi.dedup.....5983895ea745d50f8e26f8398cbb848b
Full Text :
https://doi.org/10.1093/ageing/afab146