Hospital in the home: a randomised controlled trial

Caplan, Gideon A.; Brennan, Nicholas; Brown, Ann

doi:10.5694/j.1326-5377.1999.tb123549.x

Cited by 26 publications

(52 citation statements)

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“…Adverse events and complications have been reported in various management scenarios, although inpatient care has been most extensively studied. [7][8][9][10][11][12] The new management environment of HITH is likely to be associated with low rates of AE and complications as HITH patients are usually relatively well and without significant comorbidity. In this study, most patients were managed in their homes with a family member as carer, as expected.…”

Section: Discussionmentioning

confidence: 99%

“…Our reported unplanned readmission rate (8.7%) was lower than the 13.7% reported for in the HITH group by Caplan et al . 7 Wilson et al . 8 noted a 14.1% unplanned readmission rate after discharge from the index hospital admission, but the number of days post discharge, and the patient group demographics and illnesses were not specified.…”

Section: Discussionmentioning

confidence: 99%

“…Management of HITH patients has been shown to be cost-effective [1][2][3][4] and associated with a high level of patient satisfaction. [4][5][6][7] The adverse events (AE) and complications experienced by hospital in-patients have been investigated. [7][8][9][10][11][12] In the Quality in Australian Health Care Study, Wilson et al .…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6][7] The adverse events (AE) and complications experienced by hospital in-patients have been investigated. [7][8][9][10][11][12] In the Quality in Australian Health Care Study, Wilson et al . 8 reviewed 14 179 admissions to Australian hospitals in 1992.…”

Section: Introductionmentioning

confidence: 99%

“…Complications associated with hospital admission (confusion, falls, phlebitis, bowel and urinary problems) have been investigated by Caplan et al . 7 In their randomized controlled trial of 100 Australian patients, they concluded that there was a lower incidence of confusion and urinary and bowel complications among HITH patients compared to hospitalized patients. However, this study lacked power to demonstrate a significant difference in AE rates between the two patient groups.…”

Section: Introductionmentioning

confidence: 99%

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Adverse events and complications among patients admitted to hospital in the home directly from the emergency department

Liu

Taylor

2002

Emergency Medicine

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Introduction: The nature and incidence of adverse events and complications among patients admitted from the emergency department to hospital in the home has not been investigated. This study aimed to investigate this problem and make recommendations for prevention strategies. Methods: This was an explicit retrospective chart review of patients admitted from the emergency department directly to hospital in the home between 22 February 1995 and 1 September 2000. A data extraction document was designed specifically for the study and used to extract data relating to patient demographics, diagnosis, past medical history and outcome. The outcomes of interest include adverse events, complications and death. An adverse effect is defined as an unintended injury or complication that results in disability, death or prolonged hospital stay and is caused by health care management. These adverse events may occur prior to or during the index admission and may be noted during or after the index admission. A complication is defined as an undesirable outcome that occurs during the management but not causing disability, death or prolonged hospital stay. Results: Three hundred and fifty‐seven patients were enrolled (51.3% male; median age 52 years, range 16–96 years). Fifty‐five adverse events were identified: 49 adverse events (89%) were due to management prior to hospital in the home admission and six adverse events (10.9%) were directly attributable to hospital in the home management. This represents a rate of 1.7 adverse events per 100 hospital in the home admissions directly attributable to hospital in the home management. One hundred and eighteen complications were identified. Most complications were easily managed. Thirty‐one patients had unplanned re‐admissions and two patients died within 28 days of hospital in the home admission. Conclusion: Most patients admitted to hospital in the home from the emergency department were managed successfully. Few adverse events arose from hospital in the home treatment. Complications were common but minor in nature. Strategies for the prevention of phlebitis and constipation are recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Adverse events and complications among patients admitted to hospital in the home directly from the emergency department

Liu

Taylor

2002

Emergency Medicine

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Hospital at Home for Elderly Patients With Acute Decompensation of Chronic Heart Failure

Tibaldi¹,

Isaia²,

Scarafiotti³

et al. 2009

Arch Intern Med

109

139

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Adverse Drug Reactions Associated with Home Parenteral Therapy

Cheong

Katelaris

Sisson

et al. 2008

Pharmacy Practice and Res

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Background Few studies have investigated the incidence and management of adverse drug reactions that occur during home parenteral therapy. Aim To determine the incidence, characteristics and risk factors for adverse drug reactions associated with home parenteral therapy; to evaluate the management of these reactions; and to determine the ideal contents of an anaphylaxis kit. Method 673 consecutive patients starting home parenteral therapy were recruited from the Sydney West Area Health Service (June 2002 to November 2004). Data were collected on patient characteristics; diagnosis; known drug allergies; concurrent medications; drug dose and frequency; duration of treatment; and adverse drug reactions, their management and outcomes. Results 714 treatment courses were administered to 673 patients. Commonly treated conditions were cellulitis (313 courses; 44%), orthopaedic infections (73 courses; 10%) and wound infections (63 courses; 8.8%). Frequently prescribed drugs were cephazolin (376 courses; 50%), ceftriaxone (149 courses; 20%) and vancomycin (52 courses; 7.1%). Adverse drug reactions occurred in 38 (5.3%) courses, of which 5 were ranked as serious or life‐threatening. Adverse drug reactions included skin reactions in 18 (2.5%) courses, abdominal symptoms in 8 (1.1%) courses, and vascular symptoms in 5 (0.7%) courses. Risk factors included concurrent beta‐blocker use, which was associated with an adverse drug reaction in 9 out of 54 courses (OR 4.4; 95%CI 1.9–9.7; p = 0.0003). Conclusion There was a low incidence of adverse drug reactions with home parenteral therapy, with a small risk of serious reactions. Patients taking concurrent beta‐blockers may be at greater risk of adverse drug reactions when treated with parenteral drugs. Patients need to be screened for documented allergies, regularly monitored, and an anaphylaxis kit containing adrenaline and glucagon made available.

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Hospital in the home: a randomised controlled trial

Cited by 26 publications

References 1 publication

Adverse events and complications among patients admitted to hospital in the home directly from the emergency department

Adverse events and complications among patients admitted to hospital in the home directly from the emergency department

Hospital at Home for Elderly Patients With Acute Decompensation of Chronic Heart Failure

Adverse Drug Reactions Associated with Home Parenteral Therapy

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