What question did this study set out to answer?

To evaluate the efficacy of the Transitional Care Bridge, a proactive nurse-led transitional care intervention, in preventing functional decline among acutely hospitalized older adults.

October 29, 2010BMC Health Services ResearchOpen Access

A randomised clinical trial on a comprehensive geriatric assessment and intensive home follow-up after hospital discharge: the Transitional Care Bridge

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Why the study?

Does a nurse-led transitional care program prevent functional decline in older patients acutely admitted to the hospital?

Population

674 patients aged 65 years and older acutely admitted to the Department of Internal Medicine, hospitalized…

Comparison

Transitional care bridge program consisting of… vs Usual care after discharge.

Design

RCT, Website-based, using permuted blocks and stratified by study centre and…

Follow-up

6 months (primary), up to 12 months (secondary)

Authors

BBBianca M. BuurmanDepartment of Health and Aged Care JPJuliette L. ParlevlietGGD Amsterdam BDBob AJ van DeelenDe Kinderkliniek

Discussion

Member takes

Implication

Tests nurse-led CGA plus home follow-up post-admission in older adults; leaves open whether transitional care prevents functional decline.

Key Points

To evaluate the efficacy of the Transitional Care Bridge, a proactive nurse-led transitional care intervention, in preventing functional decline among acutely hospitalized older adults.
Multicenter, double-blind, randomized clinical trial conducted across three hospitals in the Netherlands enrolling approximately 674 acutely admitted medical patients aged 65 years and older at risk for functional decline (Trial registration: NTR 2384).
Patients receive in-hospital geriatric consultation and are randomized (stratified by site and cognitive impairment) to usual care or the intervention, consisting of an in-hospital handover and five post-discharge community nurse home visits.
Primary outcome is activities of daily living functioning at six months post-discharge measured by the Katz ADL index compared to premorbid baseline, with secondary endpoints assessed at 3, 6, and 12 months.
Trial design specifies primary efficacy comparison based on preservation of Katz ADL index scores at six months relative to pre-admission baseline functioning.
Planned secondary analyses evaluate comparative differences in survival, cognitive performance, health-related quality of life, readmission rates, and patient-caregiver satisfaction across 12 months of follow-up.

Structured PICO

Does a nurse-led transitional care program prevent functional decline in older patients acutely admitted to the hospital?

Population

674 (planned) patients aged 65 years and older acutely admitted to the Department of Internal Medicine, hospitalized for at least 48 hours, and at high risk for functional decline (ISAR-HP score ≥2).

Intervention

Transitional care bridge program consisting of integrated geriatric care during admission, a handover with a community care nurse, and five home visits after discharge (at 2 days, 2 weeks, 6 weeks, 12 weeks, and 24 weeks).

Comparator

Usual care after discharge (discharge home with a letter to the GP and standard outpatient follow-up).

Outcome

Level of ADL functioning six months after discharge compared to premorbid functioning measured with the Katz ADL index.patient reported

This study protocol describes a randomized trial evaluating whether a comprehensive geriatric assessment combined with intensive home follow-up can preserve physical functioning in older adults after acute hospital admission.

Cite This Study

Buurman et al. (2010) studied this question.

synapsesocial.com/papers/6a823032a8461dff0846c242 https://doi.org/10.1186/1472-6963-10-296

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Implication

Tests nurse-led CGA plus home follow-up post-admission in older adults; leaves open whether transitional care prevents functional decline.

A randomised clinical trial on a comprehensive geriatric assessment and intensive home follow-up after hospital discharge: the Transitional Care Bridge

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

A randomised clinical trial on a comprehensive geriatric assessment and intensive home follow-up after hospital discharge: the Transitional Care Bridge

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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