Transitional care interventions to reduce readmission in patients with chronic obstructive pulmonary disease: A meta-analysis of randomized controlled trials
Min Liu
Yang Zhang
Dan-Dan Li
Jing Sun
摘要：Objective: To objectively assess the effect of transitional care on readmission for patients with chronic obstructive pulmonary disease.Methods: The PubMed, Science Direct, Web of Science, Cochrane Library, CNKI, and Wanfang databases were searched for relevant randomized controlled trials (RCTs) published from January 1990 through April 2016. The quality of eligible studies was assessed by two investigators. The primary outcome assessed was readmission for COPD and all-cause readmission. The pooled effect sizes were expressed as the relative risk and standard mean difference with 95% confidence intervals. Heterogeneity among studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0) and determined with an I2 statistic.Results: A total of seven RCTs that included 1879 participants who met the inclusion criteria were analyzed. The results of subgroup analysis showed significant differences in readmission for COPD at the 6 month and 18 month time points and all-cause readmission at the 18 month follow-up. Transitional care could reduce readmission for COPD at the 6 month [RR = 0.51, 95% CI (0.38,0.68), P < 0.00001] and 18 month time points [RR = 0.56, 95% CI (0.45,0.69), P < 0.00001, and also reduce all-cause readmission after 18 months [RR = 0.72, 95% CI (0.62,0.84), P < 0.0001]. The reduction of all-cause readmission between the intervention and control groups in the 2nd year, however, was less than that in the 1st year.Conclusions: Transitional care is beneficial to reducing readmission for patients with COPD. Duration of≥ 6 and ≤ 18 months are more effective, and the effect weakens over intervention time, especially after the end of intervention. Both durations point to the importance of ongoing intervention and reinforcement after the end of intervention.
机标关键词：obstructive pulmonary diseaserandomized controlled trialsSystematic Reviewsrelative risk
资助基金：We also thank Wenmin Sun, the director of the nursing department at Chengnan Hospital, for valuable discussion. Funding from Jiangsu Provincial Commission of Health and Family Planning Foundation (H2015032)
论文发表日期：2017-01-01
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：8( 84-91 )
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