Effectiveness of Multidisciplinary Transitional Care Interventions on Functional Status, Quality of Life and Readmission Rates in Stroke Patients: A Systematic Review and Meta-Analysis.

Abstract

Aim: To evaluate the effectiveness of multidisciplinary transitional care interventions on functional status, quality of life and readmission rates of stroke patients.

Design: Quantitative systematic review and meta-analysis.

Methods: Studies with interventions to ease the hospital-to-home transition of stroke patients that were delivered by multidisciplinary teams consisting of registered healthcare professionals from at least two disciplines were included. Cochrane Risk of Bias tool was used for quality appraisal.

Data sources: Seven electronic databases (PubMed, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Scopus and Web of Science) were searched for randomised controlled trials delivering transitional care interventions to hospitalised stroke patients.

Results: Thirty-one randomised controlled trials were included in the final review. The studies featured multidisciplinary teams of two to nine professionals, most commonly nurses, physicians and physiotherapists. Although multidisciplinary care improved functional status and quality of life scores, the impact on readmission rates was inconclusive. Meta-analysis revealed significant improvements in functional status when care involved physicians, care coordinators (often nurses) or had teams of more than two healthcare professionals. Significant improvement in quality of life was also reported when care involved physicians or in teams with more than two healthcare professionals.

Conclusions: Multidisciplinary transitional care interventions show promise in improving functional status and quality of life after stroke. Their effectiveness depends on team composition and coordination, particularly the inclusion of physicians and care coordinators. Future research should address reporting gaps and evaluate broader strategies to reduce hospital readmissions.

Implications for profession and patient care: Impact (Addressing) What problem did the study address? ○ The effectiveness of multidisciplinary transitional care interventions for stroke patients. ○ Evaluated the role of various healthcare professionals within these teams. What were the main findings? ○ Multidisciplinary transitional care interventions significantly enhance stroke patients' functional status, especially within the first 3 months. ○ Teams with care coordinators (often nurses) and supportive physicians improve functional outcomes, with effective communication being crucial despite underreporting of specific practices. ○ Teams comprising of more than two health professionals can significantly improve stroke patients' functional status. Where and on whom will the research have an impact? ○ Healthcare institutions and providers: The findings can guide healthcare institutions in developing and implementing effective transitional care services for stroke patients. ○ Stroke patients: Patients receiving multidisciplinary transitional care are likely to experience enhanced functional recovery and improved ability to perform daily activities. ○ Policymakers and researchers: The study highlights the need for more detailed reporting and research on communication practices within multidisciplinary teams and the importance of evaluating underreported outcomes like readmission rates.

Reporting method: Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) checklist.

Patient or public contribution: No Patient or Public Contribution.