The Effectiveness of Transition Interventions to Support Older Patients From Hospital to Home: A Systematic Scoping Review

O’Donnell, Renée; Savaglio, Melissa; Skouteris, Helen; Banaszak-Holl, Jane; Moran, Chris; Morris, Heather; Vicary, Dave; Ayton, Darshini

doi:10.1177/0733464820968712

Cited by 8 publications

(7 citation statements)

References 38 publications

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“…Revisão de Literatura sobre a eficácia das intervenções de TC, para apoiar idosos do hospital para casa verificou que os que se beneficiaram de educação personalizada, com intervenções orientadas a metas que promovam sua capacidade de autocuidado, tiveram resultados mais eficientes de saúde e bem-estar. (32) Neste estudo, registou-se discordância de 51,92% para o item 12 e de 16,67% para o item 15. Resultado semelhante foi observado no sul do Brasil em pesquisa sobre a TC de pacientes com doenças crônicas, que também verificou maiores percentuais de discordância sobre uso de medicamentos e seus efeitos colaterais.…”

Section: Discussionunclassified

Transição do cuidado de pessoas idosas do hospital para casa

Tomazela¹,

Valente²,

Lima³

et al. 2023

Acta Paulista De Enfermagem

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Conflitos de interesse: nada a declarar.Resumo Objetivo: Analisar a qualidade da Transição do Cuidado de idosos que receberam alta do hospital para casa. Métodos: Estudo observacional transversal, realizado com 156 idosos, após internação em hospital público, localizado no município de Piracicaba, estado de São Paulo. Os dados foram coletados em prontuário eletrônico do paciente e por ligações telefônicas com idosos, seus familiares e/ou cuidadores, até quatro semanas após alta hospitalar. Foram utilizados questionário com dados sociodemográficos e instrumento Care Transitions Measure, versão validada para o Brasil. Resultados: A duração média da última internação foi de 8,27 dias causada, majoritariamente (72,44 %) por COVID-19 e 75% dos idosos apresentaram entre 1 e 3 comorbidades, sendo a hipertensão arterial sistêmica (57,7%) a mais frequente. A média de escore do CTM 15 -Brasil foi 68,6. O Fator 1 -Preparação para o autogerenciamento obteve o maior escore (70,5) e o Fator 4 -Plano de Cuidados, o menor (59,14). Houve correlação positiva entre os 4 fatores do Care Transitions Measure, também entre estes fatores e do número de medicamentos utilizados para tratamento dos idosos, de acordo com a Classificação Anatômica Terapêutica Química.Conclusão: Evidenciou-se a qualidade da Transição do Cuidado no hospital, próxima do valor considerado satisfatório, sendo dois dos quatro fatores com pontuação maior que 70; entretanto há necessidade de adoção de estratégias para melhorar o processo de alta do hospital para casa, principalmente, no que se refere a preferências asseguradas e plano de cuidado dos idosos.

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Section: Discussionunclassified

Transição do cuidado de pessoas idosas do hospital para casa

Tomazela¹,

Valente²,

Lima³

et al. 2023

Acta Paulista De Enfermagem

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“…The assessment of participation should begin during hospitalization to enable early identification and to improve the transition process from the hospital to the community. Indeed, goal-directed transition interventions that are designed to meet older patient's unique needs were previously recommended (O'Donnell et al, 2021), and maintaining participation can serve as their ultimate goal.…”

Section: Discussionmentioning

confidence: 99%

Many Paths to Recovery: Comparing Basic Function and Participation in High-Functioning Older Adults After Acute Hospitalization

et al. 2022

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Function after acute hospitalization is mostly operationalized by Basic Activities of Daily Living (BADL), a limited concept that overshadows a wide range of instrumental, social, and recreational activities, otherwise referred to as participation. Participation is important for patients’ health and quality of life after hospitalization. This study focuses on high-functioning older adults, examining functional recovery after hospitalization by comparing BADL assessment with assessment of participation at one and three months following discharge relative to pre-hospitalization. Quantitative data were collected from 72 participants divided into two age groups of hospitalized older adults (age 65–74, n = 38; age ≥75, n = 34), followed by home visits after 1 month and telephone interviews 3 months after discharge. Both groups experienced a significantly greater decline in participation, compared with BADL, which were mostly preserved. A comprehensive assessment of participation better captures functional changes in high-functioning older adults. Early identification of participation withdrawal is crucial for preventing disability.

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“…Over the last couple of decades, research has shown diverging effects on readmission and mortality among older medical patients. Some studies have reported positive impacts, while others have reported no or negative impacts [17,18,[33][34][35][36][37]. Other studies found major implementation bottlenecks due to lack of resources, and information and organisational problems [38,39].…”

Section: Comparison With Previous Researchmentioning

confidence: 99%

Effects of a transitional care intervention on readmission among older medical inpatients: a quasi-experimental study

Rasmussen

Barat

Riis³

et al. 2022

Eur Geriatr Med

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Purpose To evaluate the effect of a transitional care intervention (TCI) on readmission among older medical inpatients. Methods This non-randomised quasi-experimental study was conducted at Horsens Regional Hospital in Denmark from 1 February 2017 to 31 December 2018. Inclusion criteria were patients ≥ 75 years old admitted for at least 48 h. First, patients were screened for eligibility. Then, the allocation to the intervention or control group was performed according to the municipality of residence. Patients living in three municipalities were offered the hospital-based intervention, and patients living in a fourth municipality were allocated to the control group. The intervention components were (1) discharge transportation with a home visit, (2) a post-discharge cross-sectorial video conference and (3) seven-day telephone consultation. The primary outcome was 30-day unplanned readmission. Secondary outcomes were 30- and 90-day mortality and days alive and out of hospital (DAOH). Results The study included 1205 patients (intervention: n = 615; usual care: n = 590). In the intervention group, the median age was 84.3 years and 53.7% were females. In the control group, the median age was 84.9 years and 57.5% were females. The 30-day readmission rates were 20.8% in the intervention group and 20.2% in the control group. Adjusted relative risk was 1.00 (95% confidence interval: 0.80, 1.26; p = 0.99). No significant difference was found between the groups for the secondary outcomes. Conclusion The TCI did not impact readmission, mortality or DAOH. Future research should conduct a pilot test, address intervention fidelity and consider real-world challenges. Trial registration Clinical trial number: NCT04796701. Registration date: 24 February 2021.

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The Effectiveness of Transition Interventions to Support Older Patients From Hospital to Home: A Systematic Scoping Review

Cited by 8 publications

References 38 publications

Transição do cuidado de pessoas idosas do hospital para casa

Transição do cuidado de pessoas idosas do hospital para casa

Many Paths to Recovery: Comparing Basic Function and Participation in High-Functioning Older Adults After Acute Hospitalization

Effects of a transitional care intervention on readmission among older medical inpatients: a quasi-experimental study

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