Effectiveness of person- and family-centred care transition interventions on patient- oriented outcomes: A systematic review.
Chantal Backman, Julie Chartrand, Michelle Crick and 3 others
PMID 33570290WHAT IT FOUND
Hospital-to-home discharge programmes centred on patients and families had mixed effects across 28 trials: 5 of 11 improved quality of life, 3 of 7 improved satisfaction, and 4 of 6 improved knowledge.
Key findings
01Across 28 trials, person- and family-centred hospital-to-home transition interventions had mixed effects on patient-oriented outcomes.
02Self-care behaviours were assessed in 10 studies; all three studies measuring physical exercise compliance found a significant difference, but only one of four medication adherence studies found a significant improvement.
03Quality of life was assessed in 11 studies and five showed a significant improvement; overall satisfaction was assessed in seven studies and three showed a significant improvement.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review did not combine the trials into a single effect estimate; it only counted how many studies were significant, so it cannot tell you how large the benefit was. The interventions were very different bundles, from four to 19 of 27 possible person- and family-centred elements, so the active ingredient is unclear. Many trials had risk-of-bias concerns: 11 of 28 showed high risk on at least one domain and seven had insufficient information to determine bias. Only randomised trials were included, and grey-literature searching was limited, so relevant studies may have been missed. The review excluded emergency-department-to-home transitions, obstetrics and gynaecology care, and psychiatric or mental health services, so it says nothing about those patients. The protocol was changed to report patient-oriented outcomes separately from health-system outcomes, so this summary does not cover emergency visits or readmissions.
Declared interests
No conflicts of interest were declared.
The easy way to misread this
Do not conclude that these discharge programmes reliably improve patient outcomes. The 28 trials showed mixed effects, and because each intervention bundled several components, the review cannot identify which component produced any benefit.