The effectiveness of telephone-based post-discharge nursing care in decreasing readmission rate in patients with heart failure: A systematic review

Abstract

BACKGROUND: The importance of comprehensive discharge planning plus post discharge support intervention studies have been advocated for patients with heart failure. Telephone-based post-discharge nursing care was reported as a significant nursing care approach that is believed to promote continuity of care. However, there is a lack of systematically examined evidence to support the effectiveness of nurse-led telephone-based post-discharge care for the heart failure patients. OBJECTIVE: The purpose of this study was to examine the best available evidence to determine the effectiveness of telephone-based post-discharge nursing care of patient with HF and to quantify the effect on all-cause readmission rates of these patients. SEARCH STRATEGY: A thorough search of published and unpublished literature was conducted from 1990 to 2009. First, computer databases such as CINAHL, MEDLINE, COCHRANE EMBASE, and Dissertation Abstracts International were included and then, reference search was conducted with relevant studies. Initial keywords were "readmission," "heart failure," "*tele*", "nurs*, "post-discharge", telephone-based." SELECTION CRITERIA: Randomized controlled trial studies using the telephone-based post-discharge nursing care was selected. Outcome was defined as frequency of unplanned HF symptoms associated all-cause hospital readmission rate during the 6 months after discharge. DATA COLLECTION AND ANALYSIS: Included studies were critically evaluated for methodological quality by independent two reviewers. Data were extracted and then analyzed using the JBI-MASTARI and the RevMan 5 program. MAIN RESULTS: A total of 10 randomized controlled trial studies were included for this study. The study result showed that telephone-based post-discharge nursing care was a significant intervention especially decreasing hospital readmission rate among HF patients. CONCLUSION: The findings of this review suggest a positive effect of telephone-based post-discharge nursing care and that it is an effective intervention in decreasing readmission rate among HF patients. IMPLICATIONS FOR PRACTICE/ RESEARCH: The results of this systematic review indicate the need for well designed studies that examine other aspects of post-discharge nursing telephone interventions to decrease hospital readmission rate among HF patients including: cost-effectiveness, feasibility and appropriateness.