Components of hospital-to-home care interventions for patients with heart failure in Japan: An integrative review

Hospital-to-home care is important for improving the quality of life (QOL) of patients with heart failure (HF). However, there is little evidence of outcomes regarding hospital-to-home care interventions in Japan. Thus, this integrative review aimed to identify the components and outcomes of hospital-to-home care interventions for patients with HF in Japan. Electronic databases, such as MEDLINE, CINAHL, and Ichushi-Web, were systematically searched, and all forms of hospital-to-home care interventions in Japan were examined. Studies regarding transitional care, discharge planning, home care, and disease management were included. The characteristics and results of the intervention studies were summarized. Furthermore, we analyzed the components of hospital-to-home care interventions and considered the effective interventions for patients with HF, based on statistically significant results. Ten articles including nine interventions were reviewed. The average age of intervention participants ranged from 64 to 77.5 years old, and the sample sizes in the intervention groups ranged from 11 to 192 participants. The intervention components were categorized as follows: "hospital-based components," "home- and outpatient-based components," and "both hospital- and home-based components." The main intervention components comprised structured education, lifetime counseling, and follow-ups via telephone and video calls. The clinical outcomes included readmission, mortality, and QOL, measured up to 24 months after the interventions. There was limited evidence of interventions being continued from the hospital to home, follow-up immediately after discharge, and nurse home visits in Japan. Further studies are necessary to evaluate the outcomes of patients' experiences immediately after discharge and the quality of care transition.