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Table 3 Synthesis of practice implications and RCT interventions

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

Integrative synthesis of qualitative and quantitative results in studies in PDHA
    Implications for interventions Outcomes
Reference Setting, diagnosis Intervention 1 2 2.1 3 4 5 5.1 6 7 IADL/ADL, scale: NEADL IADL/ADL, Various scales Quality of Life, scale: EQ-5D Quality of Life various scales Mobility Fear of Falling Risk of falling Risk of readmission AE
Effect (MD or RR), 95% CI
Studies  
[7] Acute care, unspecified Pre- and post- discharge visit + follow up phone calls Nr Un Nr Ad Nr Nr Nr Nr Ad MD-0.30 [− 1.32 to 0.72] MD-0.06 [− 0.27 to 0.15] RR 1.12 [0.76 to 1.66]
  Stroke rehabilitation unit, stroke Predischarge home visit Un Ad Nr Nr Nr Un Nr Nr Ad MD −5.50 [−15.58 to 4.58] MD −0.23 [− 0.66 to 0.20] MD 0.03 [−9.40 to 9.46] MD 0.00 [− 0.41 to 0.41] RR 1.41 [0.67 to 2.98] RR 3.91 [0.88 to 17.46]
[22, 25] Acute care, hip fracture Individual daily training including use of technical aids + predischarge home visit + instruction from physiotherapist how to walk with technical aids Nr Nr Nr N Nr Ad Nr Nr Nr MD 0.23 [− 0.19 to 0.66] MD − 0.27 [− 0.70 to 0.16]
[23] Rehabilitation unit, mixed Predischarge home visit Ad Ad Nr Ad Nr Un Nr Nr Nr MD 13.40 [6.88 to 19.92] MD 2.30 [0.51 to 4.10] MD 1.50 [0.00 to 3.00] MD 0.27 [− 0.98 to 1.51] MD 7.00 [− 17.36 to 31.36] RR 0.50 [0.06 to 3.91] RR 0.33 [0.02 to 6.65]
[53] Acute care and rehabilitation, hip fracture Home assessment by occupational therapist prior to discharge Un Ad Nr Ad Nr Un Nr Ad Nr MD − 0.50 [− 3.47 to 2.47] MD −0.08 [− 0.59 to 0.43] MD 0.00 [− 0.13 to 0.13] MD 0.00 [− 0.51 to 0.51] MD − 1.20 [−6.72 to 4.32] RR 0.83 [0.47 to 1.45] RR 0.55 [0.25 to 1.18] 0
[1] Geriatric acute care, unspecified Predischarge home visit + post-discharge follow up visit(s) + comprehensive in-hospital geriatric assessment Ad Nr Nr Un Nr Un Nr Ad Nr RR 0.84 [0.63 to 1.12]
[24] Geriatric acute care, unspecified Predischarge home visit + contacting potential social support + physical therapy + therapeutic modifications Ad Nr Nr Nr Nr Un Nr Nr Ad MD −2.48 [− 3.16 to − 1.80] RR 0.87 [0.50 to 1.49] RR 1.50 [0.61 to 3.69]
[2] Stroke ward / acute care, stroke Predischarge Virtual Home Assessment Ad Nr Nr Un Nr Ad Ad Un Ad MD 12.00 [− 10.57 to 34.57] MD 0.49 [− 0.51 to 1.49] MD 0.19 [− 0.08 to 0.46] MD 0.64 [− 0.37 to 1.65] MD 2.24 [0.91 to 3.56] MD − 7.80 [− 12.54 to − 3.06]
  1. Implications: 1) Use environmental assessments together with patients to provide education about hazards. 2) Conduct a functional assessment that includes living reality of the patients and helps the patient to find individual participant goals for therapy. 2.1) Consider potential patient anxieties regarding the assessment situation. 3) Use standardized procedures and materials to guide the PDHA process. Digital solutions could support the collaboration between hospital and community service providers. 4) Provide adequate (verbal and written) patient information about aim, process, assessment, results and consequences of the predischarge home assessment. 5) Provide tailored adaptations based on shared decision-making and involve explicitly patient’s ideas, solutions and expectations in planning home modifications. 5.1) Provide appropriate visualization for discussing recommended aids and home modifications. 6) Tailor the intervention components and mode of delivery to patients’ level and kind of impairments. 7) Consider specific context factors in PDHA-design
  2. AE Adverse effects of intervention, Ad Addressed, Un Unsure, Nr Not reported