A transitional care program in a technologically monitored in‐hospital facility reduces the length of hospital stay and improves multidimensional frailty in older patients: a Randomized Clinical Trial

IF 3.4 3区医学 Q2 GERIATRICS & GERONTOLOGY

Aging Clinical and Experimental Research Pub Date : 2024-08-06 DOI:10.1007/s40520-024-02821-8

Alberto Pilotto, Wanda Morganti, Marina Barbagelata, Emanuele Seminerio, Simona Morelli, Romina Custureri, Simone Dini, Barbara Senesi, Camilla Prete, Gianluca Puleo, Carlo Berutti Bergotto, Francesco Vallone, Carlo Custodero, Antonio Camurri, The PRO‐HOME Project Investigators Group

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引用次数: 0

Abstract

Background

Longer length of hospital stay (LOS) negatively affects the organizational efficiency of public health systems and both clinical and functional aspects of older patients. Data on the effects of transitional care programs based on multicomponent interventions to reduce LOS of older patients are scarce and controversial.

Aims

The PRO‐HOME study aimed to assess the efficacy in reducing LOS of a transitional care program involving a multicomponent intervention inside a technologically monitored in‐hospital discharge facility.

Methods

This is a Randomized Clinical Trial on 60 patients (≥65 years), deemed stable and dischargeable from the Acute Geriatrics Unit, equally assigned to the Control Group (CG) or Intervention Group (IG). The latter underwent a multicomponent intervention including lifestyle educational program, cognitive and physical training. At baseline, multidimensional frailty according to the Multidimensional Prognostic Index (MPI), and Health‐Related Quality of Life (HRQOL) were assessed in both groups, along with physical capacities for the IG. Enrolled subjects were evaluated after 6 months of follow‐up to assess multidimensional frailty, HRQOL, and re‐hospitalization, institutionalization, and death rates.

Results

The IG showed a significant 2‐day reduction in LOS (median days IG = 2 (2–3) vs. CG = 4 (3–6); p < 0.001) and an improvement in multidimensional frailty at 6 months compared to CG (median score IG = 0.25(0.25–0.36) vs. CG = 0.38(0.31–0.45); p = 0.040). No differences were found between the two groups in HRQOL, and re‐hospitalization, institutionalization, and death rates.

Discussion

Multidimensional frailty is a reversible condition that can be improved by reduced LOS.

Conclusions

The PRO‐HOME transitional care program reduces LOS and multidimensional frailty in hospitalized older patients.

Trial registration: ClinicalTrials.gov n. NCT06227923 (retrospectively registered on 29/01/2024).

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医院内技术监控设施中的过渡性护理计划可缩短住院时间并改善老年患者的多维度虚弱状况：随机临床试验。

背景：较长的住院时间（LOS）会对公共卫生系统的组织效率以及老年患者的临床和功能方面产生负面影响。目的："PRO-HOME "研究旨在评估一项过渡性护理计划在缩短住院时间方面的效果，该计划涉及在医院出院设施内进行技术监控的多成分干预：这是一项随机临床试验，研究对象是60名被认为病情稳定并可从急诊老年病科出院的患者（≥65岁），他们被平均分配到对照组（CG）或干预组（IG）。后者接受包括生活方式教育计划、认知和体能训练在内的多成分干预。在基线阶段，根据多维预后指数（MPI）对两组受试者的多维虚弱程度和与健康相关的生活质量（HRQOL）进行了评估，并对干预组的体能进行了评估。入组受试者在随访 6 个月后接受评估，以评估多维度虚弱程度、HRQOL 以及再住院率、住院率和死亡率：结果：IG 显著缩短了住院时间 2 天（中位天数为 IG = 2 (2-3) vs. CG = 4 (3-6)；P 讨论：多维度虚弱是一种有效的治疗方法：讨论：多维度虚弱是一种可逆的状况，可以通过缩短生命周期来改善：结论：PRO-HOME 过渡性护理计划缩短了住院老年患者的住院时间，并减轻了他们的多维虚弱程度：试验注册：ClinicalTrials.gov n. NCT06227923（2024年1月29日回顾性注册）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Aging Clinical and Experimental Research 医学-老年医学

CiteScore

7.90

自引率

5.00%

发文量

283

审稿时长

1 months

期刊介绍： Aging clinical and experimental research offers a multidisciplinary forum on the progressing field of gerontology and geriatrics. The areas covered by the journal include: biogerontology, neurosciences, epidemiology, clinical gerontology and geriatric assessment, social, economical and behavioral gerontology. “Aging clinical and experimental research” appears bimonthly and publishes review articles, original papers and case reports.