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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

Courtney, Mary, Edwards, Helen, Chang, Anne, Parker, Anthony, Finlayson, Kathleen, & Hamilton, Kyra (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), pp. 395-402.

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Abstract

Objective: To evaluate the effectiveness 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: Randomised controlled trial Setting: Tertiary metropolitan hospital, Australia Participants: 128 patients (64 intervention, 64 control) with an acute medical admission, aged >65 years and with at least one risk factor for readmission (multiple comorbidities, impaired functionality, aged >75 years, recent multiple admissions, poor social support, history of depression). Intervention: Comprehensive nursing and physiotherapy assessment and individually tailored program including exercise strategies and nurse conducted home visit and telephone follow-up; commencing in hospital and continuing following discharge for 24 weeks. Outcome measures: Emergency health service utilization (emergency hospital readmissions and visits to Emergency Department, General Practitioner, or allied health professional) and health related quality of life (SF12v2) collected at baseline and 4, 12 and 24 weeks following discharge. Results: The intervention group required significantly less emergency hospital readmissions (22% of intervention group, 47% of control group, P=0•007); and emergency GP visits (25% of intervention group, 67% of control group, P<0•001). The intervention group also reported significantly greater improvements in quality of life in comparison to the control group as measured with SF12v2 Physical Component summary scores (F(3,279)=30•43, P<0•001) and Mental Component Summary scores (F(3,279)=7•20, P<0•001).
Conclusions: Early introduction of a tailored 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.

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ID Code: 18910
Item Type: Journal Article
Keywords: hospital readmission, exercise, frail elderly, health promotion
DOI: 10.1111/j.1532-5415.2009.02138.x
ISSN: 1532-5415
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Geriatrics and Gerontology (110308)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Health Promotion (111712)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Aged Health Care (111702)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Exercise & Nutrition Sciences
Current > Schools > School of Nursing
Copyright Owner: Copyright 2009 Wiley-Blackwell
Copyright Statement: The definitive version is available at www.blackwell-synergy.com
Deposited On: 20 Mar 2009 13:59
Last Modified: 29 Feb 2012 23:54

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