Effects of a 4‐week Omaha System transitional care programme on rheumatoid arthritis patients' self‐efficacy, health status, and readmission in mainland China: A randomized controlled trial

Liu, Zhichen; Gao, Li; Zhang, Wenhao; Wang, Jing; Liu, Rongrong; Cao, Bin

doi:10.1111/ijn.12817

Cited by 12 publications

(26 citation statements)

References 39 publications

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“…[19] incorporated self-monitoring tools to track symptoms within their self-management website. Three studies looked at telephone based self-management education sessions as an intervention following hospital discharge compared to usual care [21][22][23]. One study used a mobile phone text messaging (SMS) application to improve self-management by supporting medication adherence and self-monitoring of symptoms [24].…”

Section: Outcome Of the Searchmentioning

confidence: 99%

“…One study was assessed to have high risk of attrition bias as the data was incomplete [24]. All studies were unclear or at high risk of bias in most domains, common issues included small numbers of participants and a lack of blinding [20][21][22][23].…”

Section: Quality Assessment and Risk Of Biasmentioning

confidence: 99%

“…Other high risk of bias included participation bias as only those who had a telephone or mobile phone were recruited [20][21][22][23]. The studies were of low-to-moderate quality affecting overall validity, reliability and generalisability.…”

Section: Quality Assessment and Risk Of Biasmentioning

confidence: 99%

“…Each intervention was delivered as planned with the overall aim of supporting self-management in individuals with RA. Two web-based interventions [18,19] and three telephone interventions were based on blended educational and behavioural theory [21][22][23]. Allam et al [18] & Zuidema et al [19] supported self-management through providing education and information on RA helping individuals to self-manage symptoms by targeting beliefs to affect behaviours.…”

Section: Intervention Characteristicsmentioning

confidence: 99%

“…A chat room option was available for some participants based on the theory that digital support networks may influence self-management capabilities. Behavioural theory appeared to underpin the telephone-based interventions, two were based on self-efficacy theory [22,23] and one was based on the health belief model [21]. The main aim of these interventions was to empower patients to engage in positive Two studies [20,24] had a treat to target approach which aims to improve outcomes for patients with RA.…”

Section: Intervention Characteristicsmentioning

confidence: 99%

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Tele-health interventions to support self-management in adults with rheumatoid arthritis: a systematic review

2021

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Rheumatoid arthritis (RA), a long-term auto-immune condition is a challenging condition for patients to manage. Goals of treatment include reducing pain, decreasing inflammation, and improving an individual’s overall function. Increasingly technology is being utilised to support patients to self-manage their condition. The aim of this systematic narrative review was to synthesise and critically appraise published evidence concerning the effectiveness of tele-health interventions to support self-management in RA. Bibliographic databases searched from 2014 to March 2020 included MedLINE, Embase, Cochrane Library. Search strategy combined the following concepts: (1) rheumatoid arthritis, (2) tele-health interventions, and (3) self-management. Only randomised controlled trials (RCTs) involving adults with RA were included. Titles, abstracts, full-text articles were screened, any discrepancies were checked by a second reviewer. Risk of bias was assessed using Cochrane risk of bias tool and data were extracted utilising the Cochrane data collection form for RCT interventions along with the TiDier checklist. Due to high heterogeneity, results were not meta-analysed and instead data were synthesised narratively. The search identified 98 articles, seven were included. The completed RCTs varied in the nature of the interventions, duration/severity of RA, outcomes measured and effectiveness of the interventions. The completed RCTs included a total of 791 participants Disease duration was largely between 4 and 10 years and disease severity on average was moderate. There was extensive variation in intervention components, theories underpinning theories and outcomes measured. Five RCTs reported a positive effect on factors such as disease activity, medication adherence, physical activity and self-efficacy levels. This study suggests that tele-health interventions that are well-designed, tailored and multi-faceted can help to achieve positive self-management outcomes in RA. None of the studies showed evidence of harm.

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Section: Outcome Of the Searchmentioning

confidence: 99%

Section: Quality Assessment and Risk Of Biasmentioning

confidence: 99%

Section: Quality Assessment and Risk Of Biasmentioning

confidence: 99%

Section: Intervention Characteristicsmentioning

confidence: 99%

Section: Intervention Characteristicsmentioning

confidence: 99%

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Tele-health interventions to support self-management in adults with rheumatoid arthritis: a systematic review

2021

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Transitional Care Interventions From Hospital to Community to Reduce Health Care Use and Improve Patient Outcomes

Tyler,

Hodkinson,

Planner

et al. 2023

JAMA Netw Open

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ImportanceDischarge from the hospital to the community has been associated with serious patient risks and excess service costs.ObjectiveTo evaluate the comparative effectiveness associated with transitional care interventions with different complexity levels at improving health care utilization and patient outcomes in the transition from the hospital to the community.Data SourcesCENTRAL, Embase, MEDLINE, and PsycINFO were searched from inception until August 2022.Study SelectionRandomized clinical trials evaluating transitional care interventions from hospitals to the community were identified.Data Extraction and SynthesisAt least 2 reviewers were involved in all data screening and extraction. Random-effects network meta-analyses and meta-regressions were applied. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed.Main Outcomes and MeasuresThe primary outcomes were readmission at 30, 90, and 180 days after discharge. Secondary outcomes included emergency department visits, mortality, quality of life, patient satisfaction, medication adherence, length of stay, primary care and outpatient visits, and intervention uptake.ResultsOverall, 126 trials with 97 408 participants were included, 86 (68%) of which were of low risk of bias. Low-complexity interventions were associated with the most efficacy for reducing hospital readmissions at 30 days (odds ratio [OR], 0.78; 95% CI, 0.66 to 0.92) and 180 days (OR, 0.45; 95% CI, 0.30 to 0.66) and emergency department visits (OR, 0.68; 95% CI, 0.48 to 0.96). Medium-complexity interventions were associated with the most efficacy at reducing hospital readmissions at 90 days (OR, 0.64; 95% CI, 0.45 to 0.92), reducing adverse events (OR, 0.42; 95% CI, 0.24 to 0.75), and improving medication adherence (standardized mean difference [SMD], 0.49; 95% CI, 0.30 to 0.67) but were associated with less efficacy than low-complexity interventions for reducing readmissions at 30 and 180 days. High-complexity interventions were most effective for reducing length of hospital stay (SMD, −0.20; 95% CI, −0.38 to −0.03) and increasing patient satisfaction (SMD, 0.52; 95% CI, 0.22 to 0.82) but were least effective for reducing readmissions at all time periods. None of the interventions were associated with improved uptake, quality of life (general, mental, or physical), or primary care and outpatient visits.Conclusions and RelevanceThese findings suggest that low- and medium-complexity transitional care interventions were associated with reducing health care utilization for patients transitioning from hospitals to the community. Comprehensive and consistent outcome measures are needed to capture the patient benefits of transitional care interventions.

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Nursing diagnoses and hospital readmission of patients with respiratory diseases: Findings from a case–control study

Suárez‐González,

Suárez‐Elosegui,

Arias‐Fernández

et al. 2024

Nursing Open

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AimThe rate of readmission after hospitalisation for respiratory diseases has become a common and challenging clinical problem. Social and functional patient variables could help identify cases at high risk of readmission. The aim was to identify the nursing diagnoses that were associated with readmission after hospitalisation for respiratory disease in Spain.DesignCase‐control study within the cohort of patients admitted for respiratory disease during 2016–19 in a tertiary public hospital in Spain (n = 3781).MethodsCases were patients who were readmitted within the first 30 days of discharge, and their controls were the remaining patients. All nursing diagnoses (n = 130) were collected from the electronic health record. They were then grouped into 29 informative diagnostic categories. Clinical confounder‐adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using logistic regression models.ResultsThe readmission rate was 13.1%. The nursing diagnoses categories ‘knowledge deficit’ (OR: 1.61; 95%CI: 1.13–2.31), ‘impaired skin integrity and risk of ulcer infection’ (OR: 1.45; 95%CI: 1.06–1.97) and ‘activity intolerance associated with fatigue’ (OR: 1.56; 95%CI: 1.21–2.01) were associated with an increased risk of suffering an episode of hospital readmission rate at 30% after hospital discharge, and this was independent of sociodemographic background, care variables and comorbidity.Patient or public contributionThe nursing diagnoses assigned as part of the care plan of patients during hospital admission may be useful for predicting readmissions.

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Effects of a 4‐week Omaha System transitional care programme on rheumatoid arthritis patients' self‐efficacy, health status, and readmission in mainland China: A randomized controlled trial

Cited by 12 publications

References 39 publications

Tele-health interventions to support self-management in adults with rheumatoid arthritis: a systematic review

Tele-health interventions to support self-management in adults with rheumatoid arthritis: a systematic review

Transitional Care Interventions From Hospital to Community to Reduce Health Care Use and Improve Patient Outcomes

Nursing diagnoses and hospital readmission of patients with respiratory diseases: Findings from a case–control study

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