Telephone Follow‐Up for Older Adults Discharged to Home from the Emergency Department: A Pragmatic Randomized Controlled Trial

Biese, Kevin; Busby‐Whitehead, Jan; Cai, Jianwen; Stearns, Sally C.; Roberts, Ellen; Mihas, Paul; Emmett, Doug; Zhou, Qingning; Farmer, Franklin; Kizer, John S.

doi:10.1111/jgs.15142

Cited by 58 publications

(85 citation statements)

References 45 publications

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“…Six studies, three randomized, reported hospitalization as a dichotomous outcome . Overall, there was no intervention effect for the randomized studies (relative risk [RR] = .96; 95% CI = .51‐1.83; Figure ), but the CI was wide, and intervention effects varied significantly (Q = 5.4; P = .07; I = 63%).…”

Section: Resultsmentioning

confidence: 99%

“…When considered together, the randomized studies reporting ED return visit(s) as a dichotomous outcome found no effect on ED return visit(s) (RR = 1.13; 95% CI = .94‐1.36; Figure ) . A single low ROB study (n = 345) found that a multi‐strategy intervention that used all three key components led to an increased risk of ED return visit(s) at 30 days .…”

Section: Resultsmentioning

confidence: 99%

“…A total of 2000 citations were identified from a combined search of databases, reviewing bibliographies of relevant review articles, and targeted searches of ClinicalTrials.gov and Scopus. After applying eligibility criteria, 17 articles describing 15 studies, nine randomized [30][31][32][33][34][35][36][37][38] and six nonrandomized [39][40][41][42][43][44] were included ( Figure 1).…”

Section: Literature Flow and Included Studiesmentioning

confidence: 99%

“…Nine studies, five randomized, reported effects of ED interventions on hospitalization after the index ED visit. [31][32][33]35,37,38,[40][41][42] Five evaluated multi-strategy interventions, 31,32,37,41,42 two of which included all three intervention components. 33,37 Six studies, three randomized, reported hospitalization as a dichotomous outcome.…”

Section: Hospitalization After the Ed Index Visitmentioning

confidence: 99%

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Emergency Department Interventions for Older Adults: A Systematic Review

Hughes

Freiermuth

Shepherd‐Banigan

et al. 2019

J American Geriatrics Society

109

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OBJECTIVES To evaluate the effect of emergency department (ED) interventions on clinical, utilization, and care experience outcomes for older adults. DESIGN A conceptual model informed, protocol‐based systematic review. SETTING Emergency Department (ED). PARTICIPANTS Older adults 65 years of age and older. METHODS AND MEASUREMENT Medline, Embase, CINAHL, and PsycINFO were searched for English‐language studies published through December 2017. Studies evaluating the use of one or more eligible intervention strategies (discharge planning, case management, medication safety or management, and geriatric EDs including those that cited the 2014 Geriatric ED Guidelines) with adults 65 years of age and older were included. Studies were classified by the number of intervention strategies used (ie, single strategy or multi‐strategy) and key intervention components present (ie, assessment, referral plus follow‐up, and contact both before and after ED discharge [“bridge”]). The effect of ED interventions on clinical (functional status, quality of life [QOL]), patient experience, and utilization (hospitalization, ED return visit) outcomes was evaluated. RESULTS A total of 2000 citations were identified; 17 articles describing 15 unique studies (9 randomized and 6 nonrandomized) met eligibility criteria and were included in analyses. ED interventions showed a mixed pattern of effects. Overall, there was a small positive effect of ED interventions on functional status but no effects on QOL, patient experience, hospitalization at or after the initial ED index visit, or ED return visit. CONCLUSION Studies using two or more intervention strategies may be associated with the greatest effects on clinical and utilization outcomes. More comprehensive interventions, defined as those with all three key intervention components present, may be associated with some positive outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Literature Flow and Included Studiesmentioning

confidence: 99%

Section: Hospitalization After the Ed Index Visitmentioning

confidence: 99%

See 2 more Smart Citations

Emergency Department Interventions for Older Adults: A Systematic Review

Hughes

Freiermuth

Shepherd‐Banigan

et al. 2019

J American Geriatrics Society

109

View full text Add to dashboard Cite

show abstract

“…47,48 The most intensive discharge follow up is a hospital at home programme. 47,48 The most intensive discharge follow up is a hospital at home programme.…”

Section: What Can the Ed Do?mentioning

confidence: 99%

Safe to send home? Discharge risk assessment in the emergency department

Southerland

Pearson

Hullick

et al. 2019

Emerg Medicine Australasia

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Emergency Department Care Transition Programs—Value-Based Care Interventions That Need System-Level Support

2022

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Fruhan and Bills 1 report that their quality improvement callback program for patients presenting to the emergency department (ED) was associated with a decrease in 3-day and 7-day ED revisits compared with control patients who did not receive this intervention. Patients enrolled in the callback program received an automated telephone call 2 days after discharge that asked if they had questions about their discharge instructions and whether they wanted a follow-up telephone call from a clinician. Patients who requested a follow-up telephone call were called by a physician assistant or nurse practitioner. Over 10 weeks, 8110 patients were enrolled in this study, of whom 2958 (36.5%) were enrolled in the callback program. Importantly, the language spoken by the

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Telephone Follow‐Up for Older Adults Discharged to Home from the Emergency Department: A Pragmatic Randomized Controlled Trial

Abstract: A scripted telephone call from a trained nurse to an older adult after discharge from the ED did not reduce ED or hospital return rates or death within 30 days. Clinicaltrials.gov identifier: NCT01893931z.

Cited by 58 publications

References 45 publications

Emergency Department Interventions for Older Adults: A Systematic Review

Emergency Department Interventions for Older Adults: A Systematic Review

Safe to send home? Discharge risk assessment in the emergency department

Emergency Department Care Transition Programs—Value-Based Care Interventions That Need System-Level Support

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