Key result
The Cardiac Care Bridge program is a planned randomized trial designed to evaluate whether a nurse-coordinated transitional care program reduces unplanned hospital readmission and mortality in older cardiac patients.
Why the study?
Does the Cardiac Care Bridge transitional care program reduce unplanned hospital readmission and mortality in older hospitalized cardiac patients at high risk?
RCT (n=500)
Single-blind
Stratified block randomization (1:1)
Yes
Does the Cardiac Care Bridge transitional care program reduce unplanned hospital readmission and mortality in older hospitalized cardiac patients at high risk?
This study protocol describes a randomized trial evaluating a nurse-coordinated transitional care program integrating geriatric and cardiac care to reduce readmissions and mortality in older high-risk cardiac patients.
No benefit on readmission or mortality with CCB program; leaves open whether refined targeting improves outcomes in high-risk older cardiac patients.
BACKGROUND: After hospitalization for cardiac disease, older patients are at high risk of readmission and death. Although geriatric conditions increase this risk, treatment of older cardiac patients is limited to the management of cardiac diseases. The aim of this study is to investigate if unplanned hospital readmission and mortality can be reduced by the Cardiac Care Bridge transitional care program (CCB program) that integrates case management, disease management and home-based cardiac rehabilitation. METHODS: In a randomized trial on patient level, 500 eligible patients ≥ 70 years and at high risk of readmission and mortality will be enrolled in six hospitals in the Netherlands. Included patients will receive a Comprehensive Geriatric Assessment (CGA) at admission. Randomization with stratified blocks will be used with pre-stratification by study site and cognitive status based on the Mini-Mental State Examination (15-23 vs ≥ 24). Patients enrolled in the intervention group will receive a CGA-based integrated care plan, a face-to-face handover with the community care registered nurse (CCRN) before discharge and four home visits post-discharge. The CCRNs collaborate with physical therapists, who will perform home-based cardiac rehabilitation and with a pharmacist who advices the CCRNs in medication management The control group will receive care as usual. The primary outcome is the incidence of first all-cause unplanned readmission or mortality within 6 months post-randomization. Secondary outcomes at three, six and 12 months after randomization are physical functioning, functional capacity, depression, anxiety, medication adherence, health-related quality of life, healthcare utilization and care giver burden. DISCUSSION: This study will provide new knowledge on the effectiveness of the integration of geriatric and cardiac care. TRIAL REGISTRATION: NTR6316 . Date of registration: April 6, 2017.
No takes yet. Share an insight, caveat, or question.
Verweij et al. (2018) conducted an RCT in Cardiac disease (n=500). Cardiac Care Bridge transitional care program vs. Usual care was evaluated on Incidence of first all-cause unplanned readmission or mortality within 6 months post-randomization. The Cardiac Care Bridge program is a planned randomized trial designed to evaluate whether a nurse-coordinated transitional care program reduces unplanned hospital readmission and mortality in older cardiac patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: