Nurse-led transitional care from hospital to home for patients with coronary artery disease: a systematic review protocol

BACKGROUND: The period of transfer from hospital to home is challenging for patients with coronary artery disease (CAD). Transitional care is an effective approach to bridge this gap, reduce readmission risk and improve secondary prevention. Components necessary for optimal models of transitional care in CAD are unknown. AIM: To synthesise evidence describing nurse-led transitional care model (TCM) for patients with CAD. The specific review objectives are: (1) To identify the components and characteristics of TCM for patients with CAD and (2) To evaluate the effectiveness of the TCM interventions compared with usual care. DESIGN: A systematic review (± meta-analysis) of randomised controlled trials. METHODS: Multiple databases including the Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, Cochrane Central Register of Controlled Trials, the Excerpta Medica Database, PyscINFO and Emcare will be searched. Independent screening in Covidence, data extraction and quality assessment will be undertaken by two reviewers with a third available for arbitration of disagreements. Two reviewers will use the Consolidated Standards of Reporting Trials (CONSORT) checklist to assess methodological quality, and the Cochrane Risk of Bias 2 (RoB 2) tool to assess risk of bias in included trials. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework will be used to determine certainty in the evidence. Narrative synthesis will be used to describe model components. Approaches to meta-analyses to assess effectiveness of transitional care models will be determined by type and frequency of reported outcome measures. CONCLUSION: Identifying key model components and characteristics in the context of CAD management should reveal gaps in evidence for best practice, providing opportunities to improve outcomes associated with care transitions.