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Artile 1 Comprehensive discharge follow-up in patients’ homes by GPs and district nurses of elderly patients.”
Rytter, Lars; Jakobsen, Helle Neel; Rønholt, Finn; Hammer, Anna Viola; Andreasen, Anne Helms; Nissen, Aase; Kjellberg, Jakob
Objectives. Many hospital admissions are due to inappropriate medical treatment, and discharge of fragile elderly patients involves a high risk of readmission. The
present study aimed to assess whether a follow-up programme undertaken by GPs and district nurses could improve the quality of the medical treatment and reduce the
risk of readmission of elderly newly discharged patients. Design and setting . The patients were randomized to either an intervention group receiving a structured home
visit by the GP and the district nurse one week after discharge followed by two contacts after three and eight weeks, or to a control group receiving the usual care.
Patients . A total of 331 patients aged 78+ years discharged from Glostrup Hospital, Denmark, were included. Main outcome measures . Readmission rate within 26 weeks
after discharge among all randomized patients. Control of medication, evaluated 12 weeks after discharge on 293 (89%) of the patients by an interview at home and by a
questionnaire to the GP. Results . Control-group patients were more likely to be readmitted than intervention-group patients (52% v 40%; p = 0.03). In the intervention
group, the proportions of patients who used prescribed medication of which the GP was unaware (48% vs. 34%; p = 0.02) and who did not take the medication prescribed by
the GP (39% vs. 28%; p = 0.05) were smaller than in the control group. Conclusion . The intervention shows a possible framework securing the follow-up on elderly
patients after discharge by reducing the readmission risk and improving medication control.
Submitted by: Ashley Nelson
Article 2. “Fewer emergency readmissions and better quality of life for older adults at risk of hospital readmission: a randomized controlled trial to determine the
effectiveness of a 24-week exercise and telephone follow-up program.”
Courtney M; Edwards H; Chang A; Parker A; Finlayson K; Hamilton K
Journal of the American Geriatrics Society (J AM GERIATR SOC), 2009; 57 (3): 395-402. (32 ref)
OBJECTIVES: To evaluate the effect of an exercise-based model of hospital and in-home follow-up care for older people at risk of hospital readmission on emergency
health service utilization and quality of life. DESIGN: Randomized controlled trial. SETTING: Tertiary metropolitan hospital in Australia. PARTICIPANTS: One hundred
twenty-eight patients (64 intervention, 64 control) with an acute medical admission, aged 65 and older and with at least one risk factor for readmission (multiple
comorbidities, impaired functionality, aged >or=75, recent multiple admissions, poor social support, history of depression). INTERVENTION: