Key result
Nurse telephone follow-up provides no benefit on ED returns, hospitalizations, or adherence in older patients.
Why the study?
Older patients discharged from the ED face increased risks for adverse outcomes, but the effects of telephone follow-up as a low-cost alternative to transitional care programs remain unclear.
Does a scripted telephone follow-up call from a nurse reduce ED return visits and hospitalizations, and improve discharge plan adherence in older patients discharged home from the ED?
Systematic Review (n=2,120)
Does a scripted telephone follow-up call from a nurse reduce ED return visits and hospitalizations, and improve discharge plan adherence in older patients discharged home from the ED?
A scripted telephone follow-up call from a nurse for older patients discharged from the emergency department does not significantly improve health services utilization or discharge plan adherence.
Does not support routine scripted nurse calls after ED discharge in older adults; confirms no benefit on returns, hospitalizations, or adherence.
BACKGROUND: Older patients discharged from the emergency department (ED) are at increased risk for adverse outcomes. Transitional care programs offer close surveillance after discharge, but are costly. Telephone follow-up (TFU) may be a low-cost and feasible alternative for transitional care programs, but its effects on health-related outcomes are not clear. AIM: We systematically reviewed the literature to evaluate the effects of TFU by health care professionals after ED discharge to an unassisted living environment on health-related outcomes in older patients compared to controls. METHODS: We conducted a multiple electronic database search up until December 2019 for controlled studies examining the effects of TFU by health care professionals for patients aged ≥65 years, discharged to an unassisted living environment from a hospital ED. Two reviewers independently assessed eligibility and risk of bias. RESULTS: Of the 748 citations, two randomized controlled trials (including a total of 2120 patients) met review selection criteria. In both studies, intervention group patients received a scripted telephone intervention from a trained nurse and control patients received a patient satisfaction survey telephone call or usual care. No demonstrable benefits of TFU were found on ED return visits, hospitalization, acquisition of prescribed medication, and compliance with follow-up appointments. However, many eligible patients were not included, because they were not reached or refused to participate. CONCLUSIONS: No benefits of a scripted TFU call from a nurse were found on health services utilization and discharge plan adherence by older patients after ED discharge. As the number of high-quality studies was limited, more research is needed to determine the effect and feasibility of TFU in different older populations. PROSPERO registration number CRD42019141403.
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Loon et al. (2021) conducted a systematic review in Older patients discharged home from the emergency department (n=2,120). Telephone follow-up (TFU) call vs. Patient satisfaction survey telephone call or usual care was evaluated on ED return visits, hospitalization, and discharge plan adherence. A scripted telephone follow-up call from a nurse provided no significant benefits on emergency department return visits, hospitalization, or discharge plan adherence in older patients.
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