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The nurse-coordinated cardiac care bridge transitional care programme: a randomised clinical trial
- 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
- Subjects :
- medicine.medical_specialty
Aging
medicine.medical_treatment
Pharmacist
11549 Institute of Implementation Science in Health Care
Aftercare
ageing/3
610 Medicine & health
2717 Geriatrics and Gerontology
ageing/5
030204 cardiovascular system & hematology
Patient Readmission
AcademicSubjects/MED00280
03 medical and health sciences
0302 clinical medicine
1302 Aging
Humans
Medicine
case management
Single-Blind Method
Transitional care
030212 general & internal medicine
Disease management (health)
Aged
Aged, 80 and over
Rehabilitation
business.industry
transitional care
General Medicine
Patient Discharge
Integrated care
Clinical trial
cardiac rehabilitation
ageing/17
disease management
Cardiac Care Facilities
Relative risk
cardiology
Emergency medicine
Geriatrics and Gerontology
business
Research Paper
Subjects
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