Lindhardt T, Loevgreen SM, Bang B, et al. A targeted assessment and intervention at the time of discharge reduced the risk of readmissions for short-term hospitalized older patients: a randomized controlled study. Clin Rehabil. 2019 Sep;33(9):1431-1444. doi: 10.1177/0269215519845032. Epub 2019 Apr 28. (Original study)

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.

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Physician 5 / 7
Comments from MORE raters

Physician rater

Home visits reducing readmission and improving functionality is perhaps not surprising information.

Physician rater

Similar endeavors have been tried elsewhere.

Physician rater

I do not think that the population in the study is targeted enough, nor the outcomes robust and consistent enough to change current practice.
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