Why the study?
Persons with frequent hospital admissions often have a disease burden exceeding their self-management skills, but the evidence base for telephone-based self-management interventions is poor with mixed results.
Does telephone-based self-management support improve HRQoL and reduce hospital admissions in persons at risk of emergency hospital admissions?
Does telephone-based self-management support improve HRQoL and reduce hospital admissions in persons at risk of emergency hospital admissions?
Telephone-based self-management support improves quality of life but does not reduce overall hospital admissions in patients at risk of emergency hospitalization, though it may benefit those with diabetes.
PaHS improves HRQoL overall but cuts admissions only in diabetes; extends targeted self-management evidence while leaving broad efficacy open.
BACKGROUND: Persons with frequent hospital admissions have a disease burden that may exceed their self-management skills. The evidence base of telephone-based interventions to support self-management is poor with mixed results. The aim of this study is to evaluate the effect of Proactive Health Support (PaHS): telephone-based self-management support for persons with risk of hospitalizations. METHODS: This study is a national randomised controlled trial of PaHS versus usual universal tax-funded healthcare. Participants were persons at risk of emergency hospital admissions. The intervention began with a physical start-up session followed by telephone sessions of self-management support. The two co-primary outcomes were Health-Related Quality of Life (HRQoL) (Mental Health Component Summary Score of SF36v2) analysed with mixed models and hospital admissions analysed with Poisson regression at 6 months. Secondary outcomes were at 3- and 12-month follow-up and disease subgroup analyses. RESULTS: During the study period, 6,402 persons were randomised (3,190 intervention, 3,212 control). HRQoL was significantly improved at 6 months (Est. 1.4992, P = <0.0001) and at 3 and 12 months on all 10 scales. There was no overall effect on hospital admissions at 6 months with an adjusted estimate of 0.0074 (P = 0.8691). Persons with diabetes had significant improvement of HRQoL and reduced hospital admissions. CONCLUSIONS: The PaHS intervention improved HRQoL for all participants and reduced hospital admissions for persons with diabetes only.
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Benthien et al. (2022) studied this question.
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