Early Supported Discharge and Transitional Care Management After Stroke: A Systematic Review and Meta-Analysis
ObjectiveTo investigate the available evidence on early supported discharge (ESD) and transitional care (TC) delivery service in patients with cerebrovascular disease.MethodsA systematic literature search was conducted to collect all available evidence on the use of ESD and TC services. We included...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.755316/full |
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| author | Sungju Jee Minah Jeong Nam-Jong Paik Won-Seok Kim Yong-Il Shin Sung-Hwa Ko In Sun Kwon Bo Mi Choi Yunsun Jung Wonkee Chang Min Kyun Sohn |
| author_facet | Sungju Jee Minah Jeong Nam-Jong Paik Won-Seok Kim Yong-Il Shin Sung-Hwa Ko In Sun Kwon Bo Mi Choi Yunsun Jung Wonkee Chang Min Kyun Sohn |
| author_sort | Sungju Jee |
| collection | DOAJ |
| description | ObjectiveTo investigate the available evidence on early supported discharge (ESD) and transitional care (TC) delivery service in patients with cerebrovascular disease.MethodsA systematic literature search was conducted to collect all available evidence on the use of ESD and TC services. We included cluster-randomized pragmatic trials or randomized controlled trials (RCTs) that recruited patients with stroke or transient ischemic attack to receive either conventional care or any care service intervention that included rehabilitation or support provided by professional medical personnel with the aim of accelerating and supporting home discharge. Relevant data were electronically searched through international databases (Cochrane Library, EMBASE, and PubMed) and incorporated into a summary grid to investigate research outcomes and provide a narrative synthesis. Furthermore, we compared the outcomes in terms of length of hospital stay, patient and caregiver outcomes, and mortality through meta-analysis.ResultsWe identified and included a total of 20 publications of various original randomized studies. There were 18 studies conducted in western countries and 2 in eastern countries. The meta-analysis revealed a tendency that ESD or TC could decrease the length of hospital stay more than the usual care [standardized mean difference (SMD) −0.13; 95% confidence interval (CI) −0.31 to 0.04 days; P = 0.14]. Moreover, there was a tendency that ESD resulted in better activities of daily living (ADL) than usual care (SMD 0.29; 95% CI −0.04 to 0.61; P = 0.08). Patient outcome based on modified Rankin scale (mRS) score (SMD −0.11; 95% CI −0.38 to 0.17; P = 0.45] and mortality (odds ratio 0.80; 95% CI 0.56–1.17; P = 0.25) did not reveal any significant difference. The Caregiver Strain Index revealed no difference.ConclusionWe did not find a large effect size for the use of TC and ESD. When implementing the TC and ESD model from western to Asian countries, services should be prepared and implemented in accordance with national medical rehabilitation pathways for cerebrovascular disease. |
| first_indexed | 2024-12-11T10:37:12Z |
| format | Article |
| id | doaj.art-d6e63317433349369c66e709cb28bffa |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-11T10:37:12Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-d6e63317433349369c66e709cb28bffa2022-12-22T01:10:40ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-03-011310.3389/fneur.2022.755316755316Early Supported Discharge and Transitional Care Management After Stroke: A Systematic Review and Meta-AnalysisSungju Jee0Minah Jeong1Nam-Jong Paik2Won-Seok Kim3Yong-Il Shin4Sung-Hwa Ko5In Sun Kwon6Bo Mi Choi7Yunsun Jung8Wonkee Chang9Min Kyun Sohn10Department of Rehabilitation Medicine, Chungnam National University Hospital and Chungnam National University College of Medicine, Daejeon, South KoreaDepartment of Rehabilitation Medicine, Chungnam National University Hospital and Chungnam National University College of Medicine, Daejeon, South KoreaDepartment of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South KoreaDepartment of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South KoreaDepartment of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Pusan, South KoreaDepartment of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Pusan, South KoreaClinical Trials Center, Chungnam National University Hospital, Daejeon, South KoreaDepartment of Public Health and Medical Services, Chungnam National University Hospital, Daejeon, South KoreaDepartment of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South KoreaDepartment of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South KoreaDepartment of Rehabilitation Medicine, Chungnam National University Hospital and Chungnam National University College of Medicine, Daejeon, South KoreaObjectiveTo investigate the available evidence on early supported discharge (ESD) and transitional care (TC) delivery service in patients with cerebrovascular disease.MethodsA systematic literature search was conducted to collect all available evidence on the use of ESD and TC services. We included cluster-randomized pragmatic trials or randomized controlled trials (RCTs) that recruited patients with stroke or transient ischemic attack to receive either conventional care or any care service intervention that included rehabilitation or support provided by professional medical personnel with the aim of accelerating and supporting home discharge. Relevant data were electronically searched through international databases (Cochrane Library, EMBASE, and PubMed) and incorporated into a summary grid to investigate research outcomes and provide a narrative synthesis. Furthermore, we compared the outcomes in terms of length of hospital stay, patient and caregiver outcomes, and mortality through meta-analysis.ResultsWe identified and included a total of 20 publications of various original randomized studies. There were 18 studies conducted in western countries and 2 in eastern countries. The meta-analysis revealed a tendency that ESD or TC could decrease the length of hospital stay more than the usual care [standardized mean difference (SMD) −0.13; 95% confidence interval (CI) −0.31 to 0.04 days; P = 0.14]. Moreover, there was a tendency that ESD resulted in better activities of daily living (ADL) than usual care (SMD 0.29; 95% CI −0.04 to 0.61; P = 0.08). Patient outcome based on modified Rankin scale (mRS) score (SMD −0.11; 95% CI −0.38 to 0.17; P = 0.45] and mortality (odds ratio 0.80; 95% CI 0.56–1.17; P = 0.25) did not reveal any significant difference. The Caregiver Strain Index revealed no difference.ConclusionWe did not find a large effect size for the use of TC and ESD. When implementing the TC and ESD model from western to Asian countries, services should be prepared and implemented in accordance with national medical rehabilitation pathways for cerebrovascular disease.https://www.frontiersin.org/articles/10.3389/fneur.2022.755316/fullcerebrovascular diseasecontinuity of patient caretransitional carerehabilitationearly supported discharge (ESD) |
| spellingShingle | Sungju Jee Minah Jeong Nam-Jong Paik Won-Seok Kim Yong-Il Shin Sung-Hwa Ko In Sun Kwon Bo Mi Choi Yunsun Jung Wonkee Chang Min Kyun Sohn Early Supported Discharge and Transitional Care Management After Stroke: A Systematic Review and Meta-Analysis Frontiers in Neurology cerebrovascular disease continuity of patient care transitional care rehabilitation early supported discharge (ESD) |
| title | Early Supported Discharge and Transitional Care Management After Stroke: A Systematic Review and Meta-Analysis |
| title_full | Early Supported Discharge and Transitional Care Management After Stroke: A Systematic Review and Meta-Analysis |
| title_fullStr | Early Supported Discharge and Transitional Care Management After Stroke: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Early Supported Discharge and Transitional Care Management After Stroke: A Systematic Review and Meta-Analysis |
| title_short | Early Supported Discharge and Transitional Care Management After Stroke: A Systematic Review and Meta-Analysis |
| title_sort | early supported discharge and transitional care management after stroke a systematic review and meta analysis |
| topic | cerebrovascular disease continuity of patient care transitional care rehabilitation early supported discharge (ESD) |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.755316/full |
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