Trial reportBMJ (Clinical research ed.)2013
Specialist geriatric medical assessment for patients discharged from hospital acute assessment units: randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Effectiveness of integrating primary healthcare in aftercare for older patients after discharge from tertiary hospitals-a systematic review and meta-analysis.Age and ageing · 2022Pooled it
- Pooled it
- Interventions to Promote Early Discharge and Avoid Inappropriate Hospital (Re)Admission: A Systematic Review.International journal of environmental research and public health · 2019Pooled it
- ICECAP-O, the current state of play: a systematic review of studies reporting the psychometric properties and use of the instrument over the decade since its publication.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2019Pooled it
- Interventions to improve the appropriate use of polypharmacy for older people.The Cochrane database of systematic reviews · 2018Pooled it
- Comprehensive geriatric assessment for older adults admitted to hospital.The Cochrane database of systematic reviews · 2017Pooled it
- A systematic review of instruments for measuring outcomes in economic evaluation within aged care.Health and quality of life outcomes · 2015Pooled it
- Systematic geriatric assessment for older patients with frailty in the emergency department: a randomised controlled trial.BMC geriatrics · 2021Trial
- Admission rates in a general practitioner-based versus a hospital specialist based, hospital-at-home model: ACCESS, an open-labelled randomised clinical trial of effectiveness.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Trial
- Trial
- Emergency Department Care Transitions for Patients With Cognitive Impairment: A Scoping Review.Journal of the American Medical Directors Association · 2022Article
- Variation in coded frailty syndromes in secondary care administrative data: an international retrospective exploratory study.BMJ open · 2022Article
- A scoping review of interventions for older adults transitioning from hospital to home.Journal of the American Geriatrics Society · 2021Article
- Structure and processes of emergency observation units with a geriatric focus: a scoping review.BMC geriatrics · 2021Article
- Proactive healthcare for frail elderly persons: study protocol for a prospective controlled primary care intervention in Sweden.BMJ open · 2019Article
- Avoidable readmissions seem to be reduced by early follow-up visits for geriatric patients discharged from hospital.European geriatric medicine · 2018Article
- Early geriatric follow-up visits to nursing home residents reduce the number of readmissions: a quasi-randomised controlled trial.European geriatric medicine · 2018Article
- [Profile and evolution of chronic complex patients in a subacute unit].Atencion primaria · 2017Article
- Early rehospitalizations of frail elderly patients - the role of medications: a clinical, prospective, observational trial.Drug, healthcare and patient safety · 2017Article
- Embedding comprehensive geriatric assessment in the emergency assessment unit: the impact of the COPE zone.Clinical medicine (London, England) · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
objectiveTo evaluate the effect of specialist geriatric medical management on the outcomes of at risk older people discharged from acute medical assessment units.
designIndividual patient randomised controlled trial comparing intervention with usual care.
settingTwo hospitals in Nottingham and Leicester, UK.
participants433 patients aged 70 or over who were discharged within 72 hours of attending an acute medical assessment unit and at risk of decline as indicated by a score of at least 2 on the Identification of Seniors At Risk tool.
interventionAssessment made on the acute medical assessment unit and further outpatient management by specialist physicians in geriatric medicine, including advice and support to primary care services.
main outcome measuresThe primary outcome was the number of days spent at home (for those admitted from home) or days spent in the same care home (if admitted from a care home) in the 90 days after randomisation. Secondary outcomes were determined at 90 days and included mortality, institutionalisation, dependency, mental wellbeing, quality of life, and health and social care resource use.
resultsThe two groups were well matched for baseline characteristics, and withdrawal rates were similar in both groups (5%). Mean days at home over 90 days' follow-up were 80.2 days in the control group and 79.7 in the intervention group. The 95% confidence interval for the difference in means was -4.6 to 3.6 days (P=0.31). No significant differences were found for any of the secondary outcomes.
conclusionsThis specialist geriatric medical intervention applied to an at risk population of older people attending and being discharged from acute medical units had no effect on patients' outcomes or subsequent use of secondary care or long term care.
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