TY - JOUR
T1 - Comparison of effects between home visits with telephone calls and telephone calls only for transitional discharge support
T2 - A randomised controlled trial
AU - Wong, Frances Kam Yuet
AU - Chow, Susan Ka Yee
AU - Chan, Tony Moon Fai
AU - Tam, Stanley Kui Fu
N1 - Funding Information:
The work described in this paper was fully supported by a grant from the Research Grants Council of the Hong Kong Special Administrative Region, China (RGC Ref No 547909).
PY - 2014/1
Y1 - 2014/1
N2 - Background: home visits and telephone calls are two often used approaches in transitional care but their differential effects are unknown. Objective: to examine the overall effects of a transitional care programme for discharged medical patients and the differential effects of telephone calls only. Design: randomised controlled trial. Setting: a regional hospital in Hong Kong. Participants: patients discharged from medical units fitting the inclusion criteria (n = 610) were randomly assigned to: control ('control', n = 210), home visits with calls ('home', n = 196) and calls only ('call', n = 204). Intervention: the home groups received alternative home visits and calls and the call groups calls only for 4 weeks. The control group received two placebo calls. The nurse case manager was supported by nursing students in delivering the interventions. Results: the home visit group (after 4 weeks 10.7%, after 12 weeks 21.4%) and the call group (11.8, 20.6%) had lower readmission rates than the control group (17.6, 25.7%). Significance differences were detected in intention-to-treat (ITT) analysis for the home and intervention group (home and call combined) at 4 weeks. In the per-protocol analysis (PPA) results, significant differences were found in all groups at 4 weeks. There was significant improvement in quality of life, self-efficacy and satisfaction in both ITT and PPA for the study groups. Conclusions: this study has found that bundled interventions involving both home visits and calls are more effective in reducing readmissions. Many of the transitional care programmes use all-qualified nurses, and this study reveals that a mixed skills model seems to bring about positive effects as well.
AB - Background: home visits and telephone calls are two often used approaches in transitional care but their differential effects are unknown. Objective: to examine the overall effects of a transitional care programme for discharged medical patients and the differential effects of telephone calls only. Design: randomised controlled trial. Setting: a regional hospital in Hong Kong. Participants: patients discharged from medical units fitting the inclusion criteria (n = 610) were randomly assigned to: control ('control', n = 210), home visits with calls ('home', n = 196) and calls only ('call', n = 204). Intervention: the home groups received alternative home visits and calls and the call groups calls only for 4 weeks. The control group received two placebo calls. The nurse case manager was supported by nursing students in delivering the interventions. Results: the home visit group (after 4 weeks 10.7%, after 12 weeks 21.4%) and the call group (11.8, 20.6%) had lower readmission rates than the control group (17.6, 25.7%). Significance differences were detected in intention-to-treat (ITT) analysis for the home and intervention group (home and call combined) at 4 weeks. In the per-protocol analysis (PPA) results, significant differences were found in all groups at 4 weeks. There was significant improvement in quality of life, self-efficacy and satisfaction in both ITT and PPA for the study groups. Conclusions: this study has found that bundled interventions involving both home visits and calls are more effective in reducing readmissions. Many of the transitional care programmes use all-qualified nurses, and this study reveals that a mixed skills model seems to bring about positive effects as well.
KW - Home visits
KW - Hospital readmissions
KW - Older people
KW - Telephone calls
KW - Transitional discharge support
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U2 - 10.1093/ageing/aft123
DO - 10.1093/ageing/aft123
M3 - Article
C2 - 23978408
AN - SCOPUS:84890322526
SN - 0002-0729
VL - 43
SP - 91
EP - 97
JO - Age and Ageing
JF - Age and Ageing
IS - 1
M1 - aft123
ER -