Comment on “Effectiveness of Multidisciplinary Transitional Care Interventions on Functional Status, Quality of Life and Readmission Rates in Stroke Patients: A Systematic Review and Meta‐Analysis”

We read with great interest the systematic review and meta-analysis by Tan et al. investigating the effectiveness of multidisciplinary transitional care for stroke patients (Tan et al. 2026). This work makes a valuable contribution to the field by clarifying the association between team composition and key outcomes, addressing a critical gap in understanding how multidisciplinary collaboration translates to improved care for stroke survivors. The rigorous methodology, adherence to PRISMA guidelines, and comprehensive synthesis of 31 randomised controlled trials further enhance the credibility of its findings. Tan et al. appropriately highlight that multidisciplinary transitional care significantly improves functional status and quality of life, with teams including physicians and care coordinators (often nurses) or comprising more than two professionals yielding the most robust effects. However, the inconclusive impact on readmission rates warrants further discussion. This ambiguity may stem from two key factors overlooked in the review: first, heterogeneity in the definition of “unplanned readmission” across included studies (e.g., 30-day vs. 90-day readmission, stroke-specific vs. all-cause readmission), which complicates meta-analytic synthesis (Soh et al. 2020); second, insufficient consideration of post-discharge follow-up duration—short-term assessments (≤ 3 months) may fail to capture delayed readmission risks associated with incomplete functional recovery or medication non-adherence (Markle-Reid et al. 2023). Standardisation of readmission metrics and longer follow-up periods in future trials would help resolve this uncertainty. Additionally, the review's global scope masks potential cultural and contextual differences in transitional care delivery. For instance, in low- and middle-income countries, resource constraints may limit the involvement of multiple professionals, requiring adapted models centered on key providers (e.g., nurse-led coordination) (Michael et al. 2025). Similarly, cultural values influencing family caregiver involvement (e.g., the central role of family in post-stroke care in East Asian contexts) may modify intervention effectiveness, yet this was not addressed in the subgroup analyses. Incorporating contextual factors and cultural adaptability into future reviews would enhance the generalisability of findings. Finally, the review identifies functional status and quality of life as primary beneficiaries of multidisciplinary care, but patient-reported outcomes beyond quality of life—such as caregiver burden, treatment adherence, and health literacy—are understudied. Given that caregiver burnout is a major predictor of unplanned readmission (Morkisch et al. 2020), integrating caregiver-focused components into transitional care interventions and evaluating their impact could help address the unresolved readmission puzzle. In conclusion, Tan et al.'s systematic review provides a solid foundation for understanding multidisciplinary transitional care in stroke management. Its findings underscore the importance of team composition in improving functional recovery and quality of life, while highlighting critical gaps in addressing readmission rates, collaboration mechanisms, and contextual adaptability. Future research should prioritise standardised outcome metrics, explicit evaluation of communication strategies, and culturally tailored interventions to fully realise the potential of multidisciplinary transitional care in optimising stroke outcomes globally. The author has nothing to report. The author has nothing to report. The author has nothing to report. The author declares no conflicts of interest. Data sharing not applicable to this article as no datasets were generated or analysed during the current study.