The Cardiac Care Bridge randomized trial in high-risk older cardiac patients: A mixed-methods process evaluation.

This article is a process evaluation, not the effectiveness trial itself; it mainly describes how much of the programme was delivered and staff views, so it does not prove the programme changes patient outcomes. Fidelity data came from hospital charts and self-reported logbooks, and missing logbook entries were counted as care not delivered, which may understate delivery if care was given but not recorded. Only 19 healthcare professionals were interviewed, and other collaborating disciplines were not included, so the views may not represent all staff involved. The patients were very old and frail, with mean age 82 years, and many had risks such as delirium, falls, ADL limitations, or malnutrition, so the findings may not apply to less frail cardiac patients. The denominators for some key elements were not all 153 patients because some elements were not feasible, so percentages are not directly comparable across all components.

No conflict of interest was declared by the authors. The paper names the funder as Nederlandse Organisatie voor Wetenschap.

Do not take the clinicians' confidence in the programme as evidence it worked. The trial did not show a significant difference in the main readmission and mortality outcome, and only 67% of intended care was delivered.