急诊科出院回家的老年患者接到电话随访对健康相关结局的影响：对照研究的系统评价
The effect of a telephone follow-up call for older patients, discharged home from the emergency department on health-related outcomes: a systematic review of controlled studies.
作者信息
van Loon-van Gaalen Merel, van Winsen Britt, van der Linden M Christien, Gussekloo Jacobijn, van der Mast Roos C
机构信息
Emergency Department, Haaglanden Medical Center, P.O. Box 432, 2501, CK, The Hague, The Netherlands.
Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
出版信息
Int J Emerg Med. 2021 Feb 18;14(1):13. doi: 10.1186/s12245-021-00336-x.
BACKGROUND
Older patients discharged from the emergency department (ED) are at increased risk for adverse outcomes. Transitional care programs offer close surveillance after discharge, but are costly. Telephone follow-up (TFU) may be a low-cost and feasible alternative for transitional care programs, but its effects on health-related outcomes are not clear.
AIM
We systematically reviewed the literature to evaluate the effects of TFU by health care professionals after ED discharge to an unassisted living environment on health-related outcomes in older patients compared to controls.
METHODS
We conducted a multiple electronic database search up until December 2019 for controlled studies examining the effects of TFU by health care professionals for patients aged ≥65 years, discharged to an unassisted living environment from a hospital ED. Two reviewers independently assessed eligibility and risk of bias.
RESULTS
Of the 748 citations, two randomized controlled trials (including a total of 2120 patients) met review selection criteria. In both studies, intervention group patients received a scripted telephone intervention from a trained nurse and control patients received a patient satisfaction survey telephone call or usual care. No demonstrable benefits of TFU were found on ED return visits, hospitalization, acquisition of prescribed medication, and compliance with follow-up appointments. However, many eligible patients were not included, because they were not reached or refused to participate.
CONCLUSIONS
No benefits of a scripted TFU call from a nurse were found on health services utilization and discharge plan adherence by older patients after ED discharge. As the number of high-quality studies was limited, more research is needed to determine the effect and feasibility of TFU in different older populations. PROSPERO registration number CRD42019141403.
背景
从急诊科（ED）出院的老年患者出现不良后果的风险增加。过渡性护理计划在出院后提供密切监测，但成本高昂。电话随访（TFU）可能是过渡性护理计划的一种低成本且可行的替代方案，但其对健康相关结局的影响尚不清楚。
目的
我们系统地回顾了文献，以评估医疗保健专业人员在急诊科出院后对入住非辅助生活环境的老年患者进行电话随访（TFU）与对照组相比对健康相关结局的影响。
方法
我们进行了多次电子数据库检索，截至2019年12月，以查找对照研究，这些研究考察了医疗保健专业人员对年龄≥65岁、从医院急诊科出院后入住非辅助生活环境的患者进行电话随访（TFU）的效果。两名评审员独立评估入选资格和偏倚风险。
结果
在748篇文献中，两项随机对照试验（共包括2120名患者）符合综述选择标准。在两项研究中，干预组患者接受了来自经过培训的护士的书面电话干预，对照组患者接受了患者满意度调查电话或常规护理。未发现电话随访（TFU）在急诊科复诊、住院、获取处方药和遵守随访预约方面有明显益处。然而，许多符合条件的患者未被纳入，因为无法联系到他们或他们拒绝参与。
结论
未发现护士进行的书面电话随访（TFU）对急诊科出院后的老年患者的医疗服务利用和出院计划依从性有任何益处。由于高质量研究的数量有限，需要更多研究来确定电话随访（TFU）在不同老年人群中的效果和可行性。PROSPERO注册号CRD42019141403。
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