The effect of a telephone follow-up call for older patients, discharged home from the emergency department on health-related outcomes: a systematic review of controlled studies

Abstract

Background Older patients discharged from the emergency department (ED) are at increased risk for adverse outcomes. Transitional care programs offer close surveillance after discharge, but are costly. Telephone follow-up (TFU) may be a low-cost and feasible alternative for transitional care programs, but its effects on health-related outcomes are not clear. Aim We systematically reviewed the literature to evaluate the effects of TFU by health care professionals after ED discharge to an unassisted living environment on health-related outcomes in older patients compared to controls. Methods We conducted a multiple electronic database search up until December 2019 for controlled studies examining the effects of TFU by health care professionals for patients aged ≥65 years, discharged to an unassisted living environment from a hospital ED. Two reviewers independently assessed eligibility and risk of bias. Results Of the 748 citations, two randomized controlled trials (including a total of 2120 patients) met review selection criteria. In both studies, intervention group patients received a scripted telephone intervention from a trained nurse and control patients received a patient satisfaction survey telephone call or usual care. No demonstrable benefits of TFU were found on ED return visits, hospitalization, acquisition of prescribed medication, and compliance with follow-up appointments. However, many eligible patients were not included, because they were not reached or refused to participate. Conclusions No benefits of a scripted TFU call from a nurse were found on health services utilization and discharge plan adherence by older patients after ED discharge. As the number of high-quality studies was limited, more research is needed to determine the effect and feasibility of TFU in different older populations. PROSPERO registration number CRD42019141403.

Care transitions and social needs: A Geriatric Emergency care Applied Research (GEAR) Network scoping review and consensus statement

“…Characteristics of the 13 systematic reviews are shown in Table S1. 40,[46][47][48][49][50][51][52][53][54][55][56][57] Of the 17 individual studies, all were published between 1996 and 2018. Among the 17 studies, eight were randomized controlled trials (RCTs), [58][59][60][61][62][63][64][65] three were pre/post studies, 66-68 two were case-control studies, 69,70 and two were nonrandomized clinical trials.…”

Developing a pharmacist-led intervention to provide transitional pharmaceutical care for hospital discharged patients: A collaboration between hospital and community pharmacists

“…Through the literature review, 209 systematic reviews were identified, among which 18 were related to pharmacists' involvement in the transition of care. 8 , 9 , 10 , 11 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 Three additional articles were identified through screening references included in the identified systematic reviews. 7 , 43 , 44 The main outcome measures in the identified articles were 30-day readmissions, emergency department visits and length of stay.…”

Telephone follow‐up to reduce unplanned hospital returns for older emergency department patients: A randomized trial

“…Based on the results of this large study, a previous RCT, and a systematic review, we advise not to introduce telephone follow‐up to reduce unplanned hospital admissions and ED return visits in older patients. 4 , 21 , 27 Future studies could evaluate the effects of this intervention on other health‐related outcomes.…”

“… 25 However, up to now only a few studies examined the feasibility and effectiveness of telephone follow‐up for older patients after discharge from the ED. 4 , 18 , 20 , 21 , 26 , 27 , 28 A recent systematic review on this topic could not demonstrate a benefit of the intervention, but only two high‐quality studies met eligibility criteria for this review. 4 , 21 , 27 Only one large randomized controlled trial (RCT) assessed the effect of telephone follow‐up for older patients on hospitalization and ED return visits within 30 days after ED discharge, reporting no benefit of the intervention.…”