The Impact of Individual-based Discharges From Acute Admission Units to Home

Study Overview
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Brief Summary
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The present non-blinded randomized controlled trial (RCT) investigates the effect of a comprehensive discharge model in adult medical patients discharged directly home from an Acute Admission Unit (AAU). In addition, eligible patients should have, at least, one hospital admission 12 months prior to index hospitalization and be discharged for further follow-up by general practitioner, home care nursing or in an out-patient clinic. The model consists of 3 main steps during the short term stay in the AAU. First, patients are screened for pre-hospital conditions that might have contributed to the index hospitalization i.e. functional ability, ongoing treatment including drug treatment, need for additional assistance to maintain daily living, relatives, and use of e.g. hearing aid, glasses, walker. Second, at point of discharge there will be a thorough assessment of the discharge plan focusing on the patients' comprehension of the discharge plan as well as accept of the suggested treatment and follow-up. Third, within 2 days after discharge the patient will receive a discharge letter by email or postal mail written in plain language and repeating the information provided in the discharge summary to the general practitioner. Subsequently, the patient will receive a telephone follow-up from the research nurse addressing the content in the discharge letter and possible unresolved issues related to the index hospitalization. Patients in the control group receives the usual discharge practice in the AAU which does not include a discharge letter to the patient and telephone follow-up after discharge. The primary endpoint is number of readmissions within 72 hours and 30 days after discharge. Secondary endpoints are healthcare service utilization within 30 days after discharge this includes number of contacts to general practitioner, out-of-hours physicians, emergency departments and if possible visits by home care nurses. Additionally, Quality-of-Life measured 30 days after discharge by the questionnaire EQ5D and Patient Experience of the discharge process is measured 7 days after discharge by a Danish national patient experience survey - serves as secondary endpoints.

Official Title
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The Impact of Individual-based Discharges From Acute Admission Units to Home on Healthcare Utilization, Quality-of-life and Patient Experience: a Randomized Controlled Study

Conditions
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Patient Discharge

Intervention / Treatment
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* Other: Individual discharge


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: medicine diagnosis discharged directly to home 1 admission during the last 12 months having a planned follow-up after discharge (general practitioner, home care nurse, out-patient clinic) read and understand Danish Exclusion Criteria: demented, living outside the council of Aarhus, included in a rival study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Individual discharge<br>Discharge based on the patients individual needs and conditions. The discharge focus on information, communication, follow-up plans and collaboration, as well as the patients understanding and accept of the discharge plan. In addition, it includes a telephone interview 2 days after discharge to home. | Other: Individual discharge<br>* See previous description in Arms<br>|
| No Intervention: Control<br>Usual discharge procedures | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Readmissions |  | 30 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Healthcare Service Utilization |  | 30 days | 
| Quality of Life (EQ5D) |  | 30 days | 
| Patients experience of the discharge process |  | 7 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Discharge, Acute Admission Unit, Randomized Controlled Trial