2015
DOI: 10.1370/afm.1844
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Transitional Care for Patients With Congestive Heart Failure: A Systematic Review and Meta-Analysis

Abstract: PURPOSE We aimed to determine the impact of transitional care interventions (TCIs) on acute health service use by patients with congestive heart failure in primary care and to identify the most effective TCIs and their optimal duration. METHODSWe conducted a systematic review and meta-analysis of randomized controlled trials, searching the Medline, PsycInfo, EMBASE, and Cochrane Library databases. We performed a meta-analysis to assess the impact of TCI on all-cause hospital readmissions and emergency departme… Show more

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Cited by 104 publications
(108 citation statements)
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References 82 publications
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“…The importance of effective communication between healthcare professionals involved with inpatient and community care (26), intense patient education to improve self-empowerment, constant medication reconciliation and therapy optimisation according to prevailing guidelines, structured outpatient follow-up for early indicators of clinical decompensation for a seamless transition from the hospital to community and the central role of specialized heart failure nurses in this complex interplay is well recognized (11,(26)(27)(28). A reliable and stable telemedical network is the facilitator for such an organizational network.…”
Section: Discussionmentioning
confidence: 99%
“…The importance of effective communication between healthcare professionals involved with inpatient and community care (26), intense patient education to improve self-empowerment, constant medication reconciliation and therapy optimisation according to prevailing guidelines, structured outpatient follow-up for early indicators of clinical decompensation for a seamless transition from the hospital to community and the central role of specialized heart failure nurses in this complex interplay is well recognized (11,(26)(27)(28). A reliable and stable telemedical network is the facilitator for such an organizational network.…”
Section: Discussionmentioning
confidence: 99%
“…Data from most studies indicate that a smooth transition in patients with HF reduces the rate of potentially avoidable readmissions and reduces the risk of adverse clinical events. 8,[10][11][12]29 …”
Section: Multidisciplinary Integrated Organization In Transitions Bementioning
confidence: 99%
“…In this review, we analyze the key aspects of transitions of care in HF and the features of the programs aimed at improving its management. 6,8,[10][11][12] HEART FAILURE UNITS: COMPONENTS AND SCIENTIFIC EVIDENCE FROM THE TRADITIONAL CARE MODEL Heart failure care models inspired by the chronic care model are called disease management programs for HF, also known as heart failure programs or heart failure units (HFU). [5][6][7]13 These models aim to reduce mortality and hospital admissions in patients with HF and improve their health-related quality of life ( Figure 1).…”
Section: Introductionmentioning
confidence: 99%
“…But early follow up visit within one week can lead to 8% and 29% risk reduction of all cause readmission and emergency department visits. 6 Many guideline directed medications are not prescribed or prescribed at a lower dose, which needs addition and optimization in follow up visits. Only a regular follow up visit by a dedicated group of people in a heart failure clinic can make it possible.…”
mentioning
confidence: 99%