Effect of Patient-Centered Transitional Care Services on Clinical Outcomes in Patients Hospitalized for Heart Failure: The PACT-HF Randomized Clinical Trial

JAMA : the Journal of the American Medical Association
Harriette G C Van SpallStuart J Connolly

Abstract

Health care services that support the hospital-to-home transition can improve outcomes in patients with heart failure (HF). To test the effectiveness of the Patient-Centered Care Transitions in HF transitional care model in patients hospitalized for HF. Stepped-wedge cluster randomized trial of 2494 adults hospitalized for HF across 10 hospitals in Ontario, Canada, from February 2015 to March 2016, with follow-up until November 2016. Hospitals were randomized to receive the intervention (n = 1104 patients), in which nurse-led self-care education, a structured hospital discharge summary, a family physician follow-up appointment less than 1 week after discharge, and, for high-risk patients, structured nurse homevisits and heart function clinic care were provided to patients, or usual care (n = 1390 patients), in which transitional care was left to the discretion of clinicians. Primary outcomes were hierarchically ordered as composite all-cause readmission, emergency department (ED) visit, or death at 3 months; and composite all-cause readmission or ED visit at 30 days. Secondary outcomes were B-PREPARED score for discharge preparedness (range: 0 [most prepared] to 22 [least prepared]); the 3-Item Care Transitions Measure (CTM-3) ...Continue Reading

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Citations

Oct 2, 2019·Journal of the American Geriatrics Society·Peter J HuckfeldtJoseph G Ouslander
May 13, 2020·Circulation. Cardiovascular Quality and Outcomes·Rohan Khera
Jan 7, 2020·European Heart Journal·John G F ClelandJohn J V McMurray
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Oct 30, 2021·Circulation. Heart Failure·Harriette G C Van SpallStuart J Connolly

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