Evidence map›Paper›PMID 27251910›Full record

Trial reportClinical medicine (London, England)2016

Randomised controlled trial of GP-led in-hospital management of homeless people ('Pathway').

Nigel Hewett, Peter Buchman, Jeflyn Musariri, Christopher Sargeant, Penny Johnson, Kushala Abeysekera, Louise Grant, Emily A Oliver, Christopher Eleftheriades, Barry McCormick and 4 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical medicine (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
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  7. Observational
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  12. Review
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  18. Improving Health Care Management in Primary Care for Homeless People: A Literature Review.International journal of environmental research and public health · 2018
    Review
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Nigel HewettMedical Director Pathway, University College Hospital Homeless Team, London, UK.
Peter BuchmanHealth E1 Homeless Medical Centre, London, UK.
Jeflyn MusaririBarts Health NHS Trust, London, UK, and Division of Medical Education, Brighton and Sussex Medical School, Brighton, UK.
Christopher SargeantBrighton and Sussex University Hospital, Brighton, UK.
Penny JohnsonBrighton and Sussex University Hospital, Brighton, UK.
Kushala AbeysekeraQueen Mary University of London, London, UK.
Louise GrantQueen Mary University of London, London, UK.
Emily A OliverQueen Mary University of London, London, UK.
Christopher EleftheriadesCentre for Health Service Economics and Organisation, Department of Primary Care, University of Oxford, Oxford, UK.
Barry McCormickCentre for Health Service Economics and Organisation, Department of Primary Care, University of Oxford, Oxford, UK.
Aidan HalliganPathway, RIP, Central Manchester University Hospitals NHS Trust and University of Manchester, Manchester, UK.
Nadine MarlinPragmatic Clinical Trials Unit, Queen Mary University of London, London, UK.
Sally KerryPragmatic Clinical Trials Unit, Queen Mary University of London, London, UK.
Graham R FosterQueen Mary University of London, London, UK.

Funding

Department of Health PB-PG-0110-21014
6 · The paper itself

Abstract

Homeless people have complex problems. GP enhanced care (Pathway) has shown benefits. We performed a randomised, -parallel arm trial at two large inner city hospitals. Inpatient homeless adults were randomly allocated to either standard care (all management by the hospital-based clinical team) or enhanced care with input from a homeless care team. The hospital data system provided healthcare usage information, and we used questionnaires to assess quality of life. 206 patients were allocated to enhanced care and 204 to usual care. Length of stay (up to 90 days after admission) did not differ between groups (standard care 14.0 days, enhanced care 13.3 days). Average reattendance at the emergency department within a year was 5.8 visits in the standard care group and 4.8 visits with enhanced care, but this decrease was not significant. -Quality of life scores after discharge (in 108 patients) improved with enhanced care (EQ-5D-5L score increased by 0.12 [95% CI 0.032 to 0.22] compared wtih 0.03 [-0.1 to 0.15; p=0.076] with standard care). The proportion of people sleeping on the streets after discharge was 14.6% in the standard care arm and 3.8% in the enhanced care arm (p=0.034). The quality-of-life cost per quality-adjusted life-year was £26,000. The Pathway approach doesn't alter length of stay but improves quality of life and reduces street -homelessness.

Indexed as

Quality of LifeAdultFemaleGeneral PractitionersHospitalizationHumansIll-Housed PersonsKaplan-Meier EstimateMaleMental Health ServicesMiddle AgedaddictionHomelessmental healthPathwayrandomised controlled trialservice provision

Identifiers

PMID27251910
PMCPMC5922699

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.