The Resource Transitional care interventions to prevent readmissions for people with heart failure, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Research Triangle Institute-University of North Carolina Evidence-based Practice Center ; investigators, Cynthia Feltner, Christine D. Jones, Crystal W. Cene, Zhi-Jie Zheng, Carla A. Sueta, Emmanuel J.L. Coker-Schwimmer, Marina Arvanitis, Kathleen N. Lohr, Jennifer Cook Middleton, Daniel E. Jonas

Transitional care interventions to prevent readmissions for people with heart failure, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Research Triangle Institute-University of North Carolina Evidence-based Practice Center ; investigators, Cynthia Feltner, Christine D. Jones, Crystal W. Cene, Zhi-Jie Zheng, Carla A. Sueta, Emmanuel J.L. Coker-Schwimmer, Marina Arvanitis, Kathleen N. Lohr, Jennifer Cook Middleton, Daniel E. Jonas

Label
Transitional care interventions to prevent readmissions for people with heart failure
Title
Transitional care interventions to prevent readmissions for people with heart failure
Statement of responsibility
prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Research Triangle Institute-University of North Carolina Evidence-based Practice Center ; investigators, Cynthia Feltner, Christine D. Jones, Crystal W. Cene, Zhi-Jie Zheng, Carla A. Sueta, Emmanuel J.L. Coker-Schwimmer, Marina Arvanitis, Kathleen N. Lohr, Jennifer Cook Middleton, Daniel E. Jonas
Creator
Contributor
Author
Sponsoring body
Subject
Genre
Language
eng
Summary
OBJECTIVES: To conduct a systematic review and meta-analysis of the efficacy, comparative effectiveness, and harms of transitional care interventions that aim to reduce readmissions and mortality for adults hospitalized with heart failure (HF). We also sought to describe the components of interventions that showed efficacy. DATA SOURCES: MEDLINE(r), Cochrane Library, CINAHL(r), ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform (January 1, 1990, to early May 2013). REVIEW METHODS: Two investigators independently selected, extracted data from, and rated risk of bias of relevant randomized controlled trials. We conducted meta-analyses using random-effects models to estimate pooled effects. We graded strength of evidence (SOE) based on established guidance. RESULTS: We included 47 trials. Most included patients with moderate to severe HF; mean ages of patients were in the 70s. Few trials reported 30-day readmission rates. A high-intensity home-visiting program reduced all-cause readmission and the composite endpoint (all-cause readmission or death) at 30 days (low SOE). Over 3 to 6 months, home-visiting programs reduced all-cause readmission (high SOE), HF-specific readmission (moderate SOE), and the composite endpoint (moderate SOE). Multidisciplinary (MDS)-HF clinic interventions reduced all-cause readmission (high SOE). Structured telephone support (STS) interventions reduced HF-specific readmission (high SOE) but not all-cause readmissions (moderate SOE). Home-visiting programs, MDS-HF clinics, and STS interventions produced a mortality benefit (moderate SOE). Neither telemonitoring nor nurse-led clinic interventions reduced readmissions or mortality. Components of interventions showing efficacy for reducing all-cause readmissions or mortality include: HF education, emphasizing self-care; HF pharmacotherapy, emphasizing promotion of adherence and evidence-based HF pharmacotherapy; and a streamlined mechanism to contact care delivery personnel (e.g., patient hotline). In general, categories of interventions that reduced all-cause readmissions or mortality were more likely to be of higher intensity, to be delivered face to face, and to be provided by MDS teams. CONCLUSIONS: Home-visiting programs and MDS-HF clinic interventions reduced all-cause readmission and mortality; STS reduced HF-specific readmission and mortality but not all-cause readmission. These interventions should receive the greatest consideration by systems or providers seeking to implement transitional care interventions for people with HF. We found no evidence assessing harms of transitional care interventions, such as increased caregiver burden
Member of
Cataloging source
DNLM
http://library.link/vocab/creatorName
Feltner, Cynthia
Funding information
Prepared for the Agency for Healthcare Research and Quality by Research Triangle Institute-University of North Carolina Evidence-based Practice Center
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • surveys of literature
NLM call number
WG 370
http://library.link/vocab/relatedWorkOrContributorName
  • United States
  • Effective Health Care Program (U.S.)
  • Research Triangle Institute-University of North Carolina Evidence-based Practice Center
Series statement
  • Comparative effectiveness review
  • AHRQ publication
Series volume
  • number 133
  • no. 14-EHC021-EF
http://library.link/vocab/subjectName
  • Heart Failure
  • Heart Failure
  • Ambulatory Care Facilities
  • Continuity of Patient Care
  • Home Care Services
  • Patient Readmission
http://bibfra.me/vocab/relation/supportingbody
SGEpYsXqBGk
Label
Transitional care interventions to prevent readmissions for people with heart failure, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Research Triangle Institute-University of North Carolina Evidence-based Practice Center ; investigators, Cynthia Feltner, Christine D. Jones, Crystal W. Cene, Zhi-Jie Zheng, Carla A. Sueta, Emmanuel J.L. Coker-Schwimmer, Marina Arvanitis, Kathleen N. Lohr, Jennifer Cook Middleton, Daniel E. Jonas
Instantiates
Publication
Note
  • "May 2014."
  • At head of title: Effective Health Care Program
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
  • cr
Carrier MARC source
rdacarrier
Content category
  • text
  • still image
Content type code
  • txt
  • sti
Content type MARC source
  • rdacontent
  • rdacontent
Control code
890851002
Extent
1 online resource (various pagings)
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
  • c
Other physical details
illustrations.
Specific material designation
remote
System control number
(OCoLC)890851002
Label
Transitional care interventions to prevent readmissions for people with heart failure, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Research Triangle Institute-University of North Carolina Evidence-based Practice Center ; investigators, Cynthia Feltner, Christine D. Jones, Crystal W. Cene, Zhi-Jie Zheng, Carla A. Sueta, Emmanuel J.L. Coker-Schwimmer, Marina Arvanitis, Kathleen N. Lohr, Jennifer Cook Middleton, Daniel E. Jonas
Publication
Note
  • "May 2014."
  • At head of title: Effective Health Care Program
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
  • cr
Carrier MARC source
rdacarrier
Content category
  • text
  • still image
Content type code
  • txt
  • sti
Content type MARC source
  • rdacontent
  • rdacontent
Control code
890851002
Extent
1 online resource (various pagings)
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
  • c
Other physical details
illustrations.
Specific material designation
remote
System control number
(OCoLC)890851002

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