Meta-Analysis of Clinical Trials That Evaluate the Effectiveness of Hospital-Initiated Postdischarge Interventions on Hospital Readmission

Branowicki, Patricia M; Vessey, Judith A.; Graham, Dionne A.; McCabe, Margaret; Clapp, Alison L; Blaine, Kevin P.; O’Neill, Margaret; Gouthro, Julie A; Snydeman, Colleen; Kline, Nancy E.; Chiang, Vincent W.; Cannon, C. Ron; Berry, Jay G.

doi:10.1097/jhq.0000000000000057

Cited by 39 publications

(35 citation statements)

References 27 publications

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“…30 Similarly, authors of a meta-analysis of clinical trials used to reduce readmissions found that postdischarge home visits and phone calls were most effective. 31 Action planning has less supporting evidence for reducing hospitalizations outside of asthma. At 1 center, individualized pain plans for sickle cell crises were associated with fewer hospitalizations compared with 4 matched hospitals.…”

Section: Discussionmentioning

confidence: 99%

Complex Care Hospital Use and Postdischarge Coaching: A Randomized Controlled Trial

Coller

Klitzner²,

Lerner³

et al. 2018

Pediatrics

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Section: Discussionmentioning

confidence: 99%

Complex Care Hospital Use and Postdischarge Coaching: A Randomized Controlled Trial

Coller

Klitzner²,

Lerner³

et al. 2018

Pediatrics

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“…To achieve triple aim objectives, reducing unnecessary hospital readmissions is desirable for payers and patients alike [2]. Several key studies have shown the values of telehealth in reducing avoidable hospital readmissions [1,[3][4][5][6][7], while others have reported inconsistent findings in regards to overall healthcare utilization: Emergency Department (ED) visits and readmissions [4,5,[8][9][10][11]. Telehealth interventions using primarily communications and surveillance technologies, show most promise in counseling and enhancing patient compliance [12].…”

Section: Introductionmentioning

confidence: 99%

Tele-transitions of care (TTOC): a 12-month, randomized controlled trial evaluating the use of Telehealth to achieve triple aim objectives

et al. 2020

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Background: Poor transitions of care leads to increased health costs, over-utilization of emergency room departments, increased re-hospitalizations and causes poor patient experiences and outcomes. This study evaluated Telehealth feasibility in improving transitions of care.Methods: This is a 12-month randomized controlled trial, evaluating the use of telehealth (remote patient monitoring and video visits) versus standard transitions of care with the primary outcomes of hospital readmission and emergency department utilization and secondary outcomes of access to care, medication management and adherence and patient engagement. Electronic Medical Record data, Health Information Exchange data and phone survey data was collected. Multi-variable logistic regression models were created to evaluate the effect of Telehealth on hospital readmission, emergency department utilization, medication adherence. Chi-square tests or Fisher's exact tests were used to compare the percentages of categorical variables between the Telehealth and control groups. T tests or Wilcoxon rank sum tests were used to compared means and medians between the two randomized groups. Results:The study conducted between June 2017 and 2018, included 102 patients. Compared with the standard of care, Telehealth patients were more likely to have medicine reconciliation (p = 0.013) and were 7 times more likely to adhere to medication than the control group (p = 0.03). Telehealth patients exhibited enthusiasm (p = 0.0001), and confidence that Telehealth could improve their healthcare (p = 0.0001). Telehealth showed no statistical significance on emergency department utilization (p = 0.691) nor for readmissions (p = 0.31). 100% of Telehealth patients found the intervention to be valuable, 98% if given the opportunity, reported they would continue using telehealth to manage their healthcare needs, and 94% reported that the remote patient monitoring technology was useful.Conclusions: Telehealth can improve transitions of care after hospital discharge improving patient engagement and adherence to medications. Although this study was unable to show the effect of Telehealth on reduced healthcare utilization, more research needs to be done in order to understand the true impact of Telehealth on preventing avoidable hospital readmission and emergency department visits.

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“…To achieve triple aim objectives, reducing unnecessary hospital readmissions is desirable for payers and patients alike (2). Several key studies have shown the values of telehealth in reducing avoidable hospital readmissions (1,(3)(4)(5)(6)(7), while others have reported inconsistent findings in regards to overall healthcare utilization: Emergency Department (ED) visits and readmissions (4,5,(8)(9)(10)(11). Telehealth interventions using primarily communications and surveillance technologies, show most promise in counseling and enhancing patient compliance (12).…”

Section: Introductionmentioning

confidence: 99%

Tele-transitions of Care (TTOC). A 12-month, Randomized Controlled Trial evaluating the use of Telehealth to achieve Triple Aim Objectives.

Noel

Messina

Hou

et al. 2020

Preprint

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Background: Poor transitions of care leads to increased health costs, over-utilization of emergency room departments, increased re-hospitalizations and causes poor patient experiences and outcomes. This study evaluated Telehealth feasibility in improving transitions of care.Methods: This is a 12-month randomized controlled trial, evaluating the use of telehealth (remote patient monitoring and video visits) versus standard transitions of care with the primary outcomes of hospital readmission and emergency department utilization and secondary outcomes of access to care, medication management and adherence and patient engagement. Electronic Medical Record data, Health Information Exchange data and phone survey data was collected. Multi-variable logistic regression models were created to evaluate the effect of Telehealth on hospital readmission, emergency department utilization, medication adherence. Chi-square tests or Fisher’s exact tests were used to compare the percentages of categorical variables between the Telehealth and control groups. T tests or Wilcoxon rank sum tests were used to compared means and medians between the two randomized groups.Results: The study conducted between June 2017 and 2018, included 102 patients. Compared with the standard of care, Telehealth patients were more likely to have medicine reconciliation (p = 0.013) and were 7 times more likely to adhere to medication than the control group (p = 0.03). Telehealth patients exhibited enthusiasm (p = 0.0001), and confidence that Telehealth could improve their healthcare (p= 0.0001). Telehealth showed no statistical significance on emergency department utilization (p = 0.691) nor for readmissions (p = 0.31). 100% of Telehealth patients found the intervention to be valuable, 98% if given the opportunity, reported they would continue using telehealth to manage their healthcare needs, and 94% reported that the remote patient monitoring technology was useful.Conclusions: Telehealth can improve transitions of care after hospital discharge improving patient engagement and adherence to medications. Although this study was unable to show the effect of Telehealth on reduced healthcare utilization, more research needs to be done in order to understand the true impact of Telehealth on preventing avoidable hospital readmission and emergency department visits.

show abstract

Meta-Analysis of Clinical Trials That Evaluate the Effectiveness of Hospital-Initiated Postdischarge Interventions on Hospital Readmission

Cited by 39 publications

References 27 publications

Complex Care Hospital Use and Postdischarge Coaching: A Randomized Controlled Trial

Complex Care Hospital Use and Postdischarge Coaching: A Randomized Controlled Trial

Tele-transitions of care (TTOC): a 12-month, randomized controlled trial evaluating the use of Telehealth to achieve triple aim objectives

Tele-transitions of Care (TTOC). A 12-month, Randomized Controlled Trial evaluating the use of Telehealth to achieve Triple Aim Objectives.

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