Trial reportBMJ open2021
Implementation of a complex intervention to improve hospital discharge: process evaluation of a cluster randomised controlled trial.
Trial report in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
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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
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Medication review in hospitalised patients to reduce morbidity and mortality.The Cochrane database of systematic reviews · 2023Pooled it
- Medication Review and Enhanced Information Transfer at Discharge of Older Patients with Polypharmacy: a Cluster-Randomized Controlled Trial in Swiss Hospitals.Journal of general internal medicine · 2023Trial
- Do process evaluations open up the 'black box' of implementation interventions in health care? A scoping review.Implementation science : IS · 2025Article
- Policy interventions for improving hospital-to-home transitions of care for older adults and informal caregivers: a qualitative study.Israel journal of health policy research · 2025Article
- Characteristics of Quality Improvement Projects in Health Services: A Systematic Scoping Review.Journal of evidence-based medicine · 2025Article
- How to fall into a new routine: factors influencing the implementation of an admission and discharge programme in hospitals and general practices.BMC health services research · 2022Article
- Development of the invasive candidiasis discharge [I Can discharge] model: a mixed methods analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo study the implementation of a cluster randomised controlled effectiveness-implementation hybrid trial testing the effectiveness of a medication review at hospital discharge combined with a communication stimulus between hospital physicians (HPs) and general practitioners (GPs) on rehospitalisation of multimorbid older patients.
designExtension of Grant's mixed method process evaluation framework to trials with multilevel clustering.
settingGeneral internal medicine wards in Swiss hospitals.
participantsConvenience samples of 15 chief physicians (of 21 hospitals participating in the effectiveness trial), 60 (74) senior HPs, 65 (164) junior HPs and 187 (411) GPs. IMPLEMENTATION STRATEGY: Two-hour teaching sessions for senior HPs on a patient-centred, checklist-guided discharge routine. PROCESS EVALUATION COMPONENTS: Data collection on recruitment, delivery and response from chief physicians (semistructured interviews), senior HPs, junior HPs, GPs (surveys) and patients (via HPs). Quantitative data were summarised using descriptive statistics, and interviews analysed using thematic analysis. OUTCOME MEASURES: Intervention dose (quantitative), implementation fidelity (qualitative), feasibility and acceptability, facilitators and barriers, implementation support strategies.
resultsRecruitment of hospitals was laborious but successful, with 21 hospitals recruited. Minimal workload and a perceived benefit for the clinic were crucial factors for participation. Intervention dose was high (95% of checklist activities carried out), but intervention fidelity was limited (discharge letters) or unknown (medication review). Recruitment and retention of patients was challenging, partly due to patient characteristics (old, frail) and the COVID-19 pandemic: Only 612 of the anticipated 2100 patients were recruited, and 31% were lost to follow-up within the first month after discharge. The intervention was deemed feasible and helpful by HPs, and the relevance of the topic appreciated by both HPs and GPs.
conclusionsThe results from this evaluation will support interpretation of the findings of the effectiveness study and may inform researchers and policy makers who aim at improving hospital discharge. TRIAL REGISTRATION NUMBER: ISRCTN18427377.
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Registered trials
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