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Fewer emergency readmissions and better quality of life for older adults at risk of hospital readmission: a randomized controlled trial to determine the effectiveness of a 24-week exercise and telephone follow-up program.
J Am Geriatr Soc. 2009 Mar; 57(3):395-402.JA

Abstract

OBJECTIVES

To evaluate the effect of an exercise-based model of hospital and in-home follow-up care for older people at risk of hospital readmission on emergency health service utilization and quality of life.

DESIGN

Randomized controlled trial.

SETTING

Tertiary metropolitan hospital in Australia.

PARTICIPANTS

One hundred twenty-eight patients (64 intervention, 64 control) with an acute medical admission, aged 65 and older and with at least one risk factor for readmission (multiple comorbidities, impaired functionality, aged >or=75, recent multiple admissions, poor social support, history of depression).

INTERVENTION

Comprehensive nursing and physiotherapy assessment and individualized program of exercise strategies and nurse-conducted home visit and telephone follow-up commencing in the hospital and continuing for 24 weeks after discharge.

MEASUREMENTS

Emergency health service utilization (emergency hospital readmissions and visits to emergency department, general practitioner (GP), or allied health professional) and health-related quality of life (Medical Outcomes Study 12-item Short Form Survey (SF-12v2) collected at baseline and 4, 12, and 24 weeks after discharge.

RESULTS

The intervention group required significantly fewer emergency hospital readmissions (22% of intervention group, 47% of control group, P=.007) and emergency GP visits (25% of intervention group, 67% of control group, P<.001). The intervention group also reported significantly greater improvements in quality of life than the control group as measured using SF-12v2 Physical Component Summary scores (F (3, 279)=30.43, P<.001) and Mental Component Summary scores (F (3, 279)=7.20, P<.001).

CONCLUSION

Early introduction of an individualized exercise program and long-term telephone follow-up may reduce emergency health service utilization and improve quality of life of older adults at risk of hospital readmission.

Authors+Show Affiliations

Faculty of Health, Queensland University of Technology, Brisbane, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19245413

Citation

Courtney, Mary, et al. "Fewer Emergency Readmissions and Better Quality of Life for Older Adults at Risk of Hospital Readmission: a Randomized Controlled Trial to Determine the Effectiveness of a 24-week Exercise and Telephone Follow-up Program." Journal of the American Geriatrics Society, vol. 57, no. 3, 2009, pp. 395-402.
Courtney M, Edwards H, Chang A, et al. Fewer emergency readmissions and better quality of life for older adults at risk of hospital readmission: a randomized controlled trial to determine the effectiveness of a 24-week exercise and telephone follow-up program. J Am Geriatr Soc. 2009;57(3):395-402.
Courtney, M., Edwards, H., Chang, A., Parker, A., Finlayson, K., & Hamilton, K. (2009). Fewer emergency readmissions and better quality of life for older adults at risk of hospital readmission: a randomized controlled trial to determine the effectiveness of a 24-week exercise and telephone follow-up program. Journal of the American Geriatrics Society, 57(3), 395-402. https://doi.org/10.1111/j.1532-5415.2009.02138.x
Courtney M, et al. Fewer Emergency Readmissions and Better Quality of Life for Older Adults at Risk of Hospital Readmission: a Randomized Controlled Trial to Determine the Effectiveness of a 24-week Exercise and Telephone Follow-up Program. J Am Geriatr Soc. 2009;57(3):395-402. PubMed PMID: 19245413.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fewer emergency readmissions and better quality of life for older adults at risk of hospital readmission: a randomized controlled trial to determine the effectiveness of a 24-week exercise and telephone follow-up program. AU - Courtney,Mary, AU - Edwards,Helen, AU - Chang,Anne, AU - Parker,Anthony, AU - Finlayson,Kathleen, AU - Hamilton,Kyra, Y1 - 2009/02/23/ PY - 2009/2/28/entrez PY - 2009/2/28/pubmed PY - 2009/3/31/medline SP - 395 EP - 402 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 57 IS - 3 N2 - OBJECTIVES: To evaluate the effect of an exercise-based model of hospital and in-home follow-up care for older people at risk of hospital readmission on emergency health service utilization and quality of life. DESIGN: Randomized controlled trial. SETTING: Tertiary metropolitan hospital in Australia. PARTICIPANTS: One hundred twenty-eight patients (64 intervention, 64 control) with an acute medical admission, aged 65 and older and with at least one risk factor for readmission (multiple comorbidities, impaired functionality, aged >or=75, recent multiple admissions, poor social support, history of depression). INTERVENTION: Comprehensive nursing and physiotherapy assessment and individualized program of exercise strategies and nurse-conducted home visit and telephone follow-up commencing in the hospital and continuing for 24 weeks after discharge. MEASUREMENTS: Emergency health service utilization (emergency hospital readmissions and visits to emergency department, general practitioner (GP), or allied health professional) and health-related quality of life (Medical Outcomes Study 12-item Short Form Survey (SF-12v2) collected at baseline and 4, 12, and 24 weeks after discharge. RESULTS: The intervention group required significantly fewer emergency hospital readmissions (22% of intervention group, 47% of control group, P=.007) and emergency GP visits (25% of intervention group, 67% of control group, P<.001). The intervention group also reported significantly greater improvements in quality of life than the control group as measured using SF-12v2 Physical Component Summary scores (F (3, 279)=30.43, P<.001) and Mental Component Summary scores (F (3, 279)=7.20, P<.001). CONCLUSION: Early introduction of an individualized exercise program and long-term telephone follow-up may reduce emergency health service utilization and improve quality of life of older adults at risk of hospital readmission. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/19245413/Fewer_emergency_readmissions_and_better_quality_of_life_for_older_adults_at_risk_of_hospital_readmission:_a_randomized_controlled_trial_to_determine_the_effectiveness_of_a_24_week_exercise_and_telephone_follow_up_program_ L2 - https://doi.org/10.1111/j.1532-5415.2009.02138.x DB - PRIME DP - Unbound Medicine ER -