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
{"title":"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。","authors":"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","doi":"10.1007/s40520-024-02821-8","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>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.</p><h3>Aims</h3><p>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.</p><h3>Methods</h3><p>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.</p><h3>Results</h3><p>The IG showed a significant 2‐day reduction in LOS (median days IG = 2 (2–3) vs. CG = 4 (3–6); <i>p</i> < 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); <i>p</i> = 0.040). No differences were found between the two groups in HRQOL, and re‐hospitalization, institutionalization, and death rates.</p><h3>Discussion</h3><p>Multidimensional frailty is a reversible condition that can be improved by reduced LOS.</p><h3>Conclusions</h3><p>The PRO‐HOME transitional care program reduces LOS and multidimensional frailty in hospitalized older patients.</p><p><i>Trial registration</i>: ClinicalTrials.gov n. NCT06227923 (retrospectively registered on 29/01/2024).</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11303417/pdf/","citationCount":"0","resultStr":"{\"title\":\"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\",\"authors\":\"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\",\"doi\":\"10.1007/s40520-024-02821-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>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.</p><h3>Aims</h3><p>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.</p><h3>Methods</h3><p>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.</p><h3>Results</h3><p>The IG showed a significant 2‐day reduction in LOS (median days IG = 2 (2–3) vs. CG = 4 (3–6); <i>p</i> < 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); <i>p</i> = 0.040). No differences were found between the two groups in HRQOL, and re‐hospitalization, institutionalization, and death rates.</p><h3>Discussion</h3><p>Multidimensional frailty is a reversible condition that can be improved by reduced LOS.</p><h3>Conclusions</h3><p>The PRO‐HOME transitional care program reduces LOS and multidimensional frailty in hospitalized older patients.</p><p><i>Trial registration</i>: ClinicalTrials.gov n. NCT06227923 (retrospectively registered on 29/01/2024).</p></div>\",\"PeriodicalId\":7720,\"journal\":{\"name\":\"Aging Clinical and Experimental Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-08-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11303417/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Aging Clinical and Experimental Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s40520-024-02821-8\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aging Clinical and Experimental Research","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s40520-024-02821-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
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
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).
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.
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