The Effectiveness of Nurse-Led Transition Care on Post-Discharge Outcomes of Adult Stroke Survivors: A Systematic Review and Meta-Analysis.
Nyagwaswa Athanas Michael, Lilian Teddy Mselle, Edith Mroso Tarimo and 1 others
PMID 40022522WHAT IT FOUND
Nurse-led stroke transition care improved quality of life by a medium amount, but did not clearly reduce mortality or readmission at 1 year.
Results varied widely across studies.
Key findings
01Compared with usual discharge care, nurse-led transition care improved quality of life by a medium pooled effect (SMD = 0.52; 95% CI = 0.20, 0.85; p = 0.002), but heterogeneity was high (I2 = 94%).
02Nurse-led transition care did not significantly reduce mortality at 1 year (OR = 1.07; 95% CI = 0.81, 1.40; p = 0.64).
03Nurse-led transition care did not significantly reduce readmission at 1 year (OR = 0.64; 95% CI = 0.34, 1.21; p = 0.17), and the pooled readmission result changed when one study was removed.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The quality-of-life result pooled studies that used 8 different measurement tools, and heterogeneity was very high (I2 = 94%). Many included studies did not report stroke severity or confirmation, so some participants may not have had true stroke. Nurses who delivered the programs knew group allocation, only 2 studies blinded participants, and 5 studies had unclear allocation concealment. The authors report funnel plot asymmetry and tests suggesting publication bias for all outcomes. The readmission result changed when one study was removed, so it was not stable. No included study was conducted in Africa, so the findings may not apply there.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not read the short-term readmission subgroup result as evidence that nurse-led transition care reliably prevents readmission. The 1-year pooled readmission result was not significant, and removing one study changed the readmission finding.