Transitional care interventions cut risk of readmission in CHF

(HealthDay)—For patients with congestive heart failure, transitional care interventions (TCIs), especially high-intensity TCIs, are effective for reducing the risks of readmission and emergency department visits, according to a review published in the November/December issue of the Annals of Family Medicine.

Isabelle Vedel, M.D., Ph.D., and Vladimir Khanassov, M.D., from McGill University in Montreal, conducted a systematic review and meta-analysis to examine the impact of TCI on all-cause hospital readmissions and emergency department visits in patients with congestive heart failure. Data were included from 41 randomized trials.

The researchers found that TCIs correlated with significantly reduced risks of readmission (relative risk, 0.92; P = 0.006) and emergency department visits (relative risk, 0.71; P = 0.04). Readmission risk was reduced with high-intensity TCIs (combining home visits with telephone follow-up, clinic visits, or both), regardless of the duration of follow-up. If implemented for a longer duration (at least six months), moderate-intensity TCIs were efficacious. Low-intensity TCIs, including only follow-up in outpatient clinics or by telephone, were found not to be efficacious.

"Clinicians and managers who implement TCIs in primary care can incorporate these results with their own health care context to determine the optimal balance between intensity and duration of TCIs," the authors write. "High-intensity interventions seem to be the best option."