1. 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
- Author
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Courtney, Mary, Edwards, Helen, Chang, Anne, Parker, Anthony, Finlayson, Kathleen, and Hamilton, Kyra
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Exercise -- Social aspects ,Clinical trials -- Social aspects ,Trademarks -- Social aspects ,Physicians (General practice) -- Social aspects ,Physical therapy -- Social aspects ,Therapeutics, Physiological -- Social aspects ,Aged -- Social aspects ,Gerontology -- Social aspects ,Depression, Mental -- Risk factors ,Depression, Mental -- Social aspects ,Hospitals -- Social aspects ,Emergency medical services -- Social aspects ,Universities and colleges -- Social aspects ,Comorbidity -- Risk factors ,Comorbidity -- Social aspects ,Health care reform -- Social aspects ,Exercise for the aged -- Social aspects ,Physical therapy for the aged -- Social aspects ,Health ,Seniors - Abstract
To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2009.02138.x Byline: Mary Courtney (*), Helen Edwards ([dagger]), Anne Chang ([dagger][double dagger]), Anthony Parker (s.), Kathleen Finlayson ([dagger]), Kyra Hamilton (*) Keywords: patient readmission; exercise; health promotion; frail elderly 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 [greater than or equal to]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.sup.[trademark]) 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 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. Author Affiliation: (*)Faculty of Health ([dagger])School of Nursing (s.)School of Human Movement Studies, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; and ([double dagger])Queensland Centre for Evidence-Based Nursing and Midwifery, Mater Health Services. Article note: Address correspondence to Kathleen Finlayson, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, 4059, Queensland, Australia. E-mail: k.finlayson@qut.edu.au
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- 2009