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Table 1 Study characteristics of included studies

From: Effects, barriers and facilitators in predischarge home assessments to improve the transition of care from the inpatient care to home in adult patients: an integrative review

Reference Study design, country, setting Participants Number, age in years, percent female (♀%) Intervention description Outcomes/aim of qualitative research Outcome measures FU in mo nths
Clemson et al., 2016 [7] RCT
Australia
Acute care, unspecified
n = 400
Intervention 80.2 (±6.4, range n.r.)
♀ 59.6%
Control
80.7 (± 5.7, range n.r.)
♀ 63.9%
Intervention
In-hospital rapport building, interview, ADL-assessment, predischarge home visit, post-discharge home-visit, telephone calls
Control
Usual care, in-hospital interview, ADL assessment, access visit if required
Functional independence, participation in ADL, unplanned readmissions, emergency department visits, recommendations NEADL [38], Late Life Disability Index (LLDI) - sub scores: frequency and limitation [39], number of: recommendations, unplanned readmissions, emergency department visits, falls, process outcomes (e.g., number of prescribed and tried equipment; effects not estimated) 3
Drummond et al., 2013 [8] RCT
UK
Stroke rehabilitation unit
n = 126
Intervention
70.64 (± 14.29, range 34–88)
♀ 54.7%
Control
73.65 (± 16.06, range 41–99)
♀ 47.8%
Intervention
One or two predischarge home visits
Control
Structured home assessment interview
ADL/IADL, mobility, unplanned readmissions, falls, emotional distress in medical settings, depressed mood of clients with stroke and significant aphasia, caregiver strain NEADL [38], Barthel Index [40], RMI [41], Number of unplanned readmissions, GHQ-28 [42], SADQ-10 [43], Caregiver Strain Index [44] 1
Hagsten et al., 2004 [22]
Hagsten et al., 2006 [25]
RCT
Sweden
Acute care, hip fractures
n = 100
Intervention
81 (± 23, range 68–91)
♀ 84%
Control
79 (± 30, range 65–95)
♀ 76%
Intervention
Individual daily training, including use of technical aids, single predischarge home visit
Control
One session of walking instruction when in hospital
ADL/IADL, health-related quality of life ADL [45], EQ. 5D [46], IADL single scales: moving around indoors; performance of light housework; getting in and out of a car, SWED-QUAL [47] subscales 2
Lannin et al., 2007 [23] RCT
Australia
Rehabilitation unit, mixed (cardiac, orthopedic trauma, neurological, orthopedic joint surgery, spinal or deconditioned)
n = 10
Intervention
80.0 (± 7, range n.r.)
♀ 100%
Control
82.4 (± 7, range n.r.)
♀ 60%
Intervention
Single predischarge home visit
Control
In-hospital consultation prior to discharge
ADL/IADL, mobility, unplanned readmissions, falls, fear of falling, community support, health-related quality of life NEADL [38], FIM [48], RNLI - Reintegration to Normal Living Index [49], Tinnetti [50], number of unplanned readmissions, number of falls, FES-I [51], EQ. 5D [46], EQ-5D VAS [52] 7
Lockwood et al., 2019 [53] RCT
Australia
Acute and rehabilitation, hip fractures
n = 77
Intervention
83.4 (± 7.1, range n.r.)
♀ 76%
Control
80.9 (± 7.3, range n.r.)
♀ 68%
Intervention
Single predischarge home visit and usual care
Control
usual care
ADL/IADL, health-related quality of life, unplanned readmissions, number of days in hospital after index discharge, falls, fear of falling, adverse events NEADL [38], SMAF [54], FIM [55], FES-I [51], EQ. 5D [46], EQ-5D VAS [52] 6
Lockwood et al., 2020 [26] b RCT, process evaluation
Australia
Acute and rehabilitation, hip fractures
n = 77
Intervention
83.4 (± 7.1, range n.r.)
♀ 76%
Control
80.9 (± 7.3, range n.r.)
♀ 68%
Intervention
Single predischarge home visit and usual care
Control
usual care
Recommendations, adherence to recommendations Number of recommendations, Number of adherence to recommendations 1
Nikolaus et al., 2003 [1] RCT
Germany
Geriatric acute care, unspecified
n = 360
Intervention
81.2
(±6.2, range 84.9–87.5)
♀ 72.4%
Control
81.9
(±6.5, range 74.4–88.4)
♀ 74.3%
Intervention
Predischarge home visit and post-discharge follow-up visit(s), comprehensive in-hospital geriatric assessment
Control
Comprehensive geriatric assessment and usual care
Falls, recommendations Number of falls, compliance with recommendations after 12 months 12
Pardessus et al., 2002 [24] RCT
France
Geriatric acute care, unspecified
n = 60
Intervention
83.51 (± 9.08, range n.r.)
♀ 76%
Control
82.9 (± 6.33, range n.r.)
♀ 80%
Intervention
Predischarge home visit
Control
Usual care
ADL/IADL,
Falls, re-hospitalization, institutionalization
IADL [56], SMAF subscales [54] ADL subscales [57] number of recurring falls, mean number of fall recurrence in former fallers, number of re-hospitalizations, number of institutionalizations 12
Provencher et al., 2020 [27] a RCT, Post-hoc analysis
Australia
Acute care, unspecified
n = 400
Intervention 80.2 (±6.4, range n.r.)
♀ 59.6%
Control
80.7 (± 5.7, range n.r.)
♀ 63.9%
Intervention
In-hospital rapport building, interview, ADL-assessment, predischarge home visit, post-discharge home visit, telephone calls
Control
Usual care, in-hospital interview, ADL assessment, access visit if required
Functional independence, participation in ADL, unplanned readmissions, emergency department visits, recommendations NEADL [34], Late Life Disability Index (LLDI) - sub scores: frequency and limitation [58], number of: recommendations, unplanned readmissions, emergency department visits, falls, process outcomes (e.g., number of prescribed and tried equipment; effects not estimated) 3
Threapleton et al., 2018 [2] RCT
UK
Stroke ward, acute care
n = 16
Intervention
72 (±21.08, range 38–90)
♀ 75%
Control
70 (± 12.6, range 46–86)
♀ 37%
Intervention
Single predischarge virtual home assessment
Control
Usual care
ADL/IADL, overall independence, mobility, fear of falling, health-related quality of life NEADL [38], Barthel- Index [40], MRS [59], Rivermead Mobility Index [41], FES-I [51], EQ. 5D [46] 6
Wales et al., 2018 [28] a RCT, economic evaluation
Australia
Acute care, unspecified
n = 400
Intervention 80.2 (±6.4, range n.r.)
♀ 59.6%
Control
80.7 (± 5.7, range n.r.)
♀ 63.9%
Intervention
In-hospital rapport building, interview, ADL-assessment, predischarge home visit, post-discharge home visit, telephone calls
Control
Usual care, in-hospital interview, ADL assessment, access visit if required
Costs for predischarge home visits costs for occupational therapy
time, travel, community follow up, hospital readmission
3
Atwal et al., 2008 [31] Semi-structured interview
UK
Geriatric acute care
Patients, main carers
n = 15
86,46 years
(range 73–97)
♀ 60%
Intervention
Single predischarge home visit
- To explore older adults’ and carers’ involvement in decisions that were made during the home visit;
- To explore older adults’ and carers’ perceptions of the home visit process
n.a. n.a.
Atwal et al., 2014a [32] Semi-structured interview; think aloud technique
UK
Acute care and community care
OTs
n = 7
♀ 71%
social services, older persons, mental health, acute care, pediatrics
Intervention
Virtual reality predischarge home assessment with interior design application
- To explore occupational therapists’ perceptions of a virtual reality interior design application (VRIDA);
- to gain insights into the feasibility of using VRIDA as a tool to aid the predischarge home visit (perceived usefulness, perceived ease of use, actual use)
n.a. n.a.
Atwal et al., 2014b [37] Semi-structured interview
UK
Acute care, intermediate care, rehabilitation,
older patients, mental health (older people)
OTs
n = 21
Intervention
Predischarge home visit / access visit
- To explore occupational therapists’ perceptions of home visits;
- To ascertain occupational therapists’ clinical reasoning with respect to conducting home visits
n.a. n.a.
Cameron et al., 2014 [33] In-depth interview, semi-structured, focus groups
Canada
Rehabilitation facility, stroke
Patients
n = 16
62 years
(range 25–87)
♀ 75%
Family caregivers n = 15
41 years
(range 23–75)
♀ 86,7%
Multiple health professionals
n = 20
Intervention
Single predischarge home visit or preparation in hospital and single/multiple predischarge weekend passes
- To explore stroke survivors’, caregivers’, and healthcare professionals’ perceptions of weekend passes offered during inpatient rehabilitation and its role in facilitating the transition home n.a. n.a.
Davis et al., 2019 [30] Semi-structured survey
Republic of Ireland
acute settings, rehabilitation settings and convalescence settings, adult patients (over 18 years)
OTs
n = 122
Intervention
Pre-discharge home visit
- To investigate clinical practice during DPHV and the clinical reasoning guiding occupational therapists within an Irish context n.a. for semistructured part quantitative part of survey: use of standardized tool, contents of home visit bag, numbers of recommendations, consensus on clinical practice n.a.
Godfrey et al., 2019 [34] Focus-group interviews
Australia
Acute or sub-acute settings from three facilities
OTs
n = 19
Multidisciplinary stakeholders
n = 8
Intervention
Pre-discharge home visit
- To understand both occupational therapists’ and multidisciplinary stakeholders’ perceptions and contemporary practice regarding decision-making and pre-discharge home visits through exploration of experience and current practice in the Australian context. Investigation of factors associated with when, how and to whom pre-discharge home visits are provided n.a.  
Hibberd, 2008 [29] Semi-structured interview
UK
Intermediate care unit
Patients
n = 4
65 years and older
♀ 50%
Intervention
Predischarge home visit / access visit
Part of an evaluation study;
- To gain patient perspectives on home visiting process -to ensure service meets needs
n.a. n.a.
Nygard et al., 2004 [35] Interviews, focus groups, participant observation
Sweden
Geriatric acute care, mixed diagnoses
Patients
n = 23
78 years
(range 68–86)
♀ 50%
Living alone
n = 12
OTs
n = 9
Intervention
Single predischarge home visit
- To describe and illustrate, from both clients’ and therapists’ perspectives, the occupational therapy interventions and recommendations that were undertaken and followed-up in common practice during predischarge home visits;
- To gain insight in the accuracy of expectations of therapists and in perceived usefulness of predischarge home visits to clients
n.a. n.a.
Threapleton et al., 2017 [3] Semi-structured interview
UK
Acute care, rehabilitation, community,
stroke
Patients
n = 8
68 years
(range 44–92)
♀ 75%
Stroke survivors n = 4
70 years
(range 61–79)
♀ 75%
OTs
n = 13
Intervention
Virtual predischarge home visit
- To explore perceptions concerning the acceptability, potential utility and limitations of the use of a virtual reality interior design application from the perspectives of therapists and patients n.a. n.a.
Whitehead et al., 2014 [36] Semi-structured interview
UK
Acute, rehabilitation, mixed, hyper acute, stroke
OTs
n = 20
Intervention
Predischarge home assessment visits
- To explore what factors occupational therapists consider when deciding which patients with a stroke need a predischarge home assessment visit n.a. n.a.
  1. FU latest time point of follow-up, n.a Not applicable, n.r. Not reported, a refers to the original RCT of Clemson et al., 2016 [7]; b refers to the original RCT of Lockwood et al., 2019 [53]