A family nurse-led intervention for reducing health services' utilization in individuals with chronic diseases: The ADVICE pilot study.

This was a small pilot with no concurrent control group, so the lower health services use after the intervention could be due to time, natural disease course, regression to the mean, extra home visits, or other care rather than teach-back alone. Participants were aged 65 years or older and were recruited from two general practices; younger and possibly more severe patients were excluded, so results may not apply broadly. Patients with important cognitive or neurological deficits, terminal disease, or cancer were excluded. Eight of 78 enrolled patients dropped out before analysis, and the analysed sample was 70. The patients received several forms of care: standard home care with functional support during activities of daily living, wound medications, vital sign checks, intravenous drug administrations, and taking blood samples, followed by nurse-led teach-back education. The contribution of any single component cannot be separated. The study did not measure knowledge retention or self-management abilities, so the mechanism for the reduction is unknown. Because it was a before-after study, repeated readmissions could create immortal bias and may have inflated apparent effectiveness.

Nothing to declare; the authors report no competing financial interests or personal relationships that could have influenced the work.

Do not conclude that family nurse practitioner teach-back education caused the reduction in readmissions and emergency visits. The study was a before-after pilot with no control group, and patients also received standard home care including functional support during activities of daily living, wound medications, vital sign checks, intravenous drug administrations, and taking blood samples, so the contribution of any single component cannot be separated.