Fasce Pineda Gerardo, Aravena Castro José M, Araya Orellana Carolina, Bustamante Muñoz Ruby, Gonzalez Andrade Francisco, Briceño Ribot Constanza, Quiroz Opazo Tiare, Araya Orellana Esperanza, Navarrete Hernandez Gonzalo
Hospital Clínico de la Universidad de Chile, Santiago, Chile; Clínica las Condes, Santiago, Chile.
Hospital Clínico de la Universidad de Chile, Santiago, Chile; Facultad de Salud, Universidad Bernardo O'Higgins, Santiago, Chile.
Rev Esp Geriatr Gerontol. 2018 Nov-Dec;53(6):337-343. doi: 10.1016/j.regg.2018.04.448. Epub 2018 Jul 4.
Re-admission to hospital by the elderly is a frequent event that is associated with complications. The aim of this article is to describe a randomised clinical trial protocol which has the aim of describing and comparing the impact of a home-based intervention by Occupational Therapists (OT) in the likelihood of re-admission at 6 months.
Randomised controlled trial conducted in medical units of the "Hospital Clínico de la Universidad de Chile" and "Hospital de la Fuerza Aérea de Chile", with 217 patients aged 60 years or older admitted for acute or decompensated chronic disease, provided that they have a person of reference after hospital discharge. The control group consists of the usual care regarding post-discharge patients. This will be compared to the experimental group that includes a home visit from OT on two occasions over a six-month period, who will apply a multicomponent intervention. Informed consent will be requested with the sociodemographic and hospital admission information, functional (Barthel index; Lawton & Brody Scale) and cognitive performance (Short Portable Mental Status Questionnaire; Functional Activities Questionnaire; Confusion Assessment Method), and comorbidity (Cumulative Illness Rating Scale for Geriatrics). Both groups will receive a telephone follow-up at 4, 12 and 24 weeks after hospital discharge.
The intervention will reduce the rate of hospital re-admissions by at least 40% at 6 months compared with usual care.
It will be useful to know the components that reduce the risk of hospital re-admissions and improve hospital discharge healthcare for elderly.
老年人再次入院是一种常见事件，且与并发症相关。本文旨在描述一项随机临床试验方案，其目的是描述和比较职业治疗师（OT）进行的家庭干预对6个月内再次入院可能性的影响。
在“智利大学临床医院”和“智利空军医院”的医疗科室进行随机对照试验，纳入217例60岁及以上因急性或失代偿性慢性病入院且出院后有照护者的患者。对照组包括对出院患者的常规护理。这将与实验组进行比较，实验组包括职业治疗师在6个月内进行两次家访，并实施多组分干预。将索取知情同意书，包括社会人口学和入院信息、功能（巴氏指数；劳顿和布罗迪量表）和认知表现（简易便携式精神状态问卷；功能活动问卷；意识模糊评估方法）以及合并症（老年累积疾病评定量表）。两组在出院后4周、12周和24周均接受电话随访。
与常规护理相比，干预将使6个月时的再次入院率至少降低40%。
了解降低再次入院风险的因素并改善老年人出院后的医疗保健将是有益的。
