TY - JOUR
T1 - Early supported discharge for older adults admitted to hospital with medical complaints
T2 - a systematic review and meta-analysis
AU - Williams, Susan
AU - Morrissey, Ann Marie
AU - Steed, Fiona
AU - Leahy, Aoife
AU - Shanahan, Elaine
AU - Peters, Catherine
AU - O'Connor, Margaret
AU - Galvin, Rose
AU - O'Riordan, Clíona
PY - 2023/1/1
Y1 - 2023/1/1
N2 - INTRODUCTION: Early supported discharge (ESD) aims to link acute and community care, allowing hospital inpatients to return home and continue to receive the necessary input from healthcare professionals that they would otherwise receive in hospital. It has been researched extensively in the stroke population, showing reduced length of stay for patients and improved functional outcomes. This systematic review aims to explore the totality of evidence for the use of ESD in an older adult population who have been hospitalised with medical complaints. METHODS: Systematic searches were conducted in MEDLINE, CINAHL, Ebsco, Cochrane Library and EMBASE. Randomised controlled trials (RCTs) and quasi-RCTs were included if they provided an ESD intervention to older adults admitted to hospital for medical complaints compared with usual inpatient care. Patient and process outcomes were explored. The Cochrane Risk of Bias Tool was used to assess methodological quality. A meta-analysis was conducted using RevMan 5.4.1. RESULTS: Five RCTs met the inclusion criteria. The quality of the trials was mixed overall, with high levels of heterogeneity. ESD demonstrated a statistically significant reduction in length of stay (MD -6.04 days, 95% CI -9.76 to -2.32) and improvements in function, cognition, and health-related quality of life, with no increased risk of long-term care admission, hospital re-admission or mortality in the ESD interventions versus usual care groups. DISCUSSION: This review demonstrates that ESD positively impacts patient and process outcomes for older adults. Further consideration should be given to exploring the experiences of those involved in ESD including older adults, family members/caregivers as well as healthcare professionals.
AB - INTRODUCTION: Early supported discharge (ESD) aims to link acute and community care, allowing hospital inpatients to return home and continue to receive the necessary input from healthcare professionals that they would otherwise receive in hospital. It has been researched extensively in the stroke population, showing reduced length of stay for patients and improved functional outcomes. This systematic review aims to explore the totality of evidence for the use of ESD in an older adult population who have been hospitalised with medical complaints. METHODS: Systematic searches were conducted in MEDLINE, CINAHL, Ebsco, Cochrane Library and EMBASE. Randomised controlled trials (RCTs) and quasi-RCTs were included if they provided an ESD intervention to older adults admitted to hospital for medical complaints compared with usual inpatient care. Patient and process outcomes were explored. The Cochrane Risk of Bias Tool was used to assess methodological quality. A meta-analysis was conducted using RevMan 5.4.1. RESULTS: Five RCTs met the inclusion criteria. The quality of the trials was mixed overall, with high levels of heterogeneity. ESD demonstrated a statistically significant reduction in length of stay (MD -6.04 days, 95% CI -9.76 to -2.32) and improvements in function, cognition, and health-related quality of life, with no increased risk of long-term care admission, hospital re-admission or mortality in the ESD interventions versus usual care groups. DISCUSSION: This review demonstrates that ESD positively impacts patient and process outcomes for older adults. Further consideration should be given to exploring the experiences of those involved in ESD including older adults, family members/caregivers as well as healthcare professionals.
UR - http://www.scopus.com/inward/record.url?scp=85148399578&partnerID=8YFLogxK
U2 - 10.22605/RRH8155
DO - 10.22605/RRH8155
M3 - Article
C2 - 36802701
AN - SCOPUS:85148399578
SN - 1445-6354
VL - 23
SP - 8155
JO - Rural and remote health
JF - Rural and remote health
IS - 1
ER -
