Trial reportJournal of the American Geriatrics Society2023
Connect-Home transitional care from skilled nursing facilities to home: A stepped wedge, cluster randomized trial.
Trial report in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 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
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.
- Reporting race and ethnicity in aging in place research: A systematic review.The Gerontologist · 2026Pooled it
- Role of recruitment bias in stepped-wedge cluster randomised controlled trials: a systematic review.BMJ open · 2025Pooled it
- Preparedness for care transitions to home and acute care use of skilled nursing facility patients.BMC geriatrics · 2025Trial
- Nurse Telephone Support for Caregivers of Older Adults at Hospital Discharge: A Randomized Clinical Trial.JAMA network open · 2024Trial
- Life-Space of Older Adults after Discharge from Skilled Nursing Facilities.Journal of the American Medical Directors Association · 2024Trial
- Health Trajectories of Skilled Nursing Facility Patients With Alzheimer's Disease and Related Dementias: Evidence for Practicing Nurses.Journal of gerontological nursing · 2024Trial
- Evaluation of injury prevention interventions using the stepped wedge cluster randomised trial design: key considerations.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2026Article
- Can I Stay, or Must I Go Now? A Cohort Study of Discharge Appeals in a Post-Acute Skilled Nursing Facility.Journal of the American Medical Directors Association · 2026Article
- Analysis of Stepped-Wedge Cluster Randomized Trials: A Tutorial Using Marginal Models.Statistics in medicine · 2026Article
- Measures and tools assessing medication self-management capability in older people across the hospital-to-home transition: a systematic scoping review.BMC geriatrics · 2025Article
- Post-Acute Transition to Home With Supportive Care (PATHS): A Novel Nurse Practitioner-Led Telehealth Intervention to Improve End-of-Life Oncology Care.Journal of pain and symptom management · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundSkilled nursing facility (SNF) patients and their caregivers who transition to home experience complications and frequently return to acute care. We tested the efficacy of the Connect-Home transitional care intervention on patient and caregiver preparedness for care at home, and other patient and caregiver-reported outcomes.
methodsWe used a stepped wedge, cluster-randomized trial design to test the intervention against standard discharge planning (control). The setting was six SNFs and six home health offices in one agency. Participants were 327 dyads of patients discharged from SNF to home and their caregivers; 11.1% of dyads in the control condition and 81.2% in the intervention condition were enrolled after onset of COVID-19. Patients were 63.9% female and mean age was 76.5 years. Caregivers were 73.7% female and mean age was 59.5 years. The Connect-Home intervention includes tools, training, and technical assistance to deliver transitional care in SNFs and patients' homes. Primary outcomes measured at 7 days included patient and caregiver measures of preparedness for care at home, the Care Transitions Measure-15 (patient) and the Preparedness for Caregiving Scale (caregiver). Secondary outcomes measured at 30 and 60 days included the McGill Quality of Life Questionnaire, Life Space Assessment, Zarit Caregiver Burden Scale, Distress Thermometer, and self-reported number of patient days in the ED or hospital in 30 and 60 days following SNF discharge.
resultsThe intervention was not associated with improvement in patient or caregiver outcomes in the planned analyses. Post-hoc analyses that distinguished between pre- and post-pandemic effects suggest the intervention may be associated with increased patient preparedness for discharge and decreased number of acute care days.
conclusionsConnect-Home transitional care did not improve outcomes in the planned statistical analysis. Post-hoc findings accounting for COVID-19 impact suggest SNF transitional care has potential to increase patient preparedness and decrease return to acute care.
Indexed as
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What OpenQuestion holds
Registered trials
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.