Hospital-initiated transitional care can improve some outcomes in adults hospitalized for stroke or myocardial infarction, according to a meta-analysis, the authors of which said more research needs to be conducted on the subject.
In background information for the analysis, which appears in the Sept. 18 issue of the Annals of Internal Medicine, researchers noted that transitional care strategies have been shown to reduce unnecessary use of health services and improve patient outcomes in chronically ill, older patients. But less is known about the benefits and harms of transitional care strategies for patients who have a new acute event.
Researchers summarized 44 studies that compared usual care with transitional care strategies for adults with acute stroke or MI. They evaluated four types of transitional care strategies: hospital-initiated support into home or intermediary care, hospital-based or community-based patient and family education, community-based models of support interventions and chronic disease management models of care.
The researchers found moderate-strength evidence that hospital-initiated support reduced length of stay for patients who had a stroke, and low-strength evidence that hospital-initiated support reduced mortality for patients who had a MI. Evidence about the other strategies was insufficient. Available evidence identified no tested interventions that have been shown to consistently improve functional recovery; quality of life; or psychosocial factors, such as strain of care, anxiety or depression, after stroke or MI, the authors wrote.
Additional well-structured research must be done in the United States before concluding that a specific approach is effective and worthy of widespread adoption for patients with acute stroke or MI, they concluded. As the U.S. population ages and the number of patients who have MI or stroke increases, it is imperative to have transitional care interventions proven to be effective in improving functional outcomes, facilitating transfer of care from a hospital-based system to a community-based system and preventing rehospitalization and adverse events.
The study is available at http://annals.org/article.aspx?articleid=1359220.