OBJECTIVE: The aim of this study was to test and compare the effect of (1) a systematic discharge assessment with targeted advice and (2) a motivational interview followed by a home visit.
DESIGN: This was a three-armed randomized controlled study.
SETTING: This study was conducted in the Medical department in a university hospital.
SUBJECTS: Patients ?65 years of age with health problems at discharge participated in the study.
INTERVENTIONS: Group A (n = 117): patients were informed of health problems and self-care interventions; Group B (n = 116): a motivational conversation targeting activities of daily living with a home care nurse and a home visit.
MAIN MEASURES: The main measures of this study were readmissions, handgrip strength, chair-to-stand test, health-related quality of life, depression signs, mortality, and call on municipality services.
RESULTS: Risk of readmission was reduced for intervention groups by 30% (A; P = 0.26) and 22 % (B; P = 0.46). Mean number of days to first readmission was 49.5 (±51.0) days for the control group (n = 116) and 57.9 (±53.6) and 67.2 (±58.1) days for the intervention groups A (P = 0.43) and B (P = 0.10), respectively. Mean loss of handgrip strength was 10.6 (±16.6) kg for men in the control group and 7 (±19.2) and 1.4 (±17.1) kg for the intervention groups A (P = 0.38) and B (P = 0.01), respectively. Health-related quality of life improved with 0.3 (±23.7) points in the control group and 7.4 (±24.4) and 3.2 (±22.3) points in the intervention groups A (P = 0.04) and B (P = 0.37), respectively. In total, 17 (16.3%) in the control group were provided with assistive devices after three months and 8 (7.3%) and 19 (17.6%) in the intervention groups A (P = 0.04) and B (P = 0.81), respectively.
CONCLUSION: The interventions reduced the risk of readmission and improved handgrip strength, quality of life, and use of assistive devices.
Home visits reducing readmission and improving functionality is perhaps not surprising information.
Similar endeavors have been tried elsewhere.
I do not think that the population in the study is targeted enough, nor the outcomes robust and consistent enough to change current practice.