Evidence map›Paper›PMID 39030939›Full record

ArticleJournal of the American Medical Directors Association2024

Paramedic-Assisted Community Evaluation After Discharge: The PACED Intervention.

Laurel O'Connor, Stephanie Sison, Kimberly Eisenstock, Kouta Ito, Sarah McGee, Xhenifer Mele, Israel Del Poza, Michael Hall, Abbey Smiley, Julie Inzerillo and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Medical Directors Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Observational
  2. A Cost Analysis of Mobile Integrated Health for Acute Care.The western journal of emergency medicine · 2026
    Article
  3. 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

15 authors.

Laurel O'ConnorDepartment of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA. Electronic address: Laurel.oconnor@umassmed.edu.
Stephanie SisonDepartment of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Kimberly EisenstockDepartment of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Kouta ItoDepartment of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Sarah McGeeDepartment of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA; Department of Family Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Xhenifer MeleDepartment of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Israel Del PozaDepartment of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Michael HallDepartment of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Abbey SmileyDepartment of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Julie InzerilloDepartment of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Kerri KinsellaDepartment of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Apurv SoniDepartment of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Eric DicksonDepartment of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
John P BroachDepartment of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
David D McManusDepartment of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.

Funding

University of Massachusetts Center for Clinical and Translational ScienceKL2TR001455 · NCATS · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI KIEFE, CATARINA I. · 2015 to 2024
$5.0M
University of Massachusetts Center for Clinical and Translational ScienceTL1TR001454 · NCATS · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI LEWIS, BRIAN C · 2015 to 2024
$3.6M
NCATS NIH HHS KL2 TR001455NCATS NIH HHS TL1 TR001454
6 · The paper itself

Abstract

objectivesEarly rehospitalization of frail older adults after hospital discharge is harmful to patients and challenging to hospitals. Mobile integrated health (MIH) programs may be an effective solution for delivering community-based transitional care. The objective of this study was to assess the feasibility and implementation of an MIH transitional care program.

designPilot clinical trial of a transitional home visit conducted by MIH paramedics within 72 hours of hospital discharge. SETTING AND

participantsPatients aged ≥65 years discharged from an urban hospital with a system-adapted eFrailty index ≥0.24 were eligible to participate.

methodsParticipants were enrolled after hospital discharge. Demographic and clinical information were recorded at enrollment and 30 days after discharge from the electronic health record. Data from a comparison group of patients excluded from enrollment due to geographical location was also abstracted. Primary outcomes were intervention feasibility and implementation, which were reported descriptively. Exploratory clinical outcomes included emergency department (ED) visits and rehospitalization within 30 days. Categorical and continuous group comparisons were conducted using χ

resultsOne hundred of 134 eligible individuals (74.6%) were enrolled (median age 81, 64% female). Forty-seven participants were included in the control group (median age 80, 55.2% female). The complete protocol was performed in 92 (92.0%) visits. Paramedics identified acute clinical problems in 23 (23.0%) visits, requested additional services for participants during 34 (34.0%) encounters, and detected medication errors during 34 (34.0%). The risk of 30-day rehospitalization was lower in the Paramedic-Assisted Community Evaluation after Discharge (PACED) group compared with the control (RR, 0.40; CI, 0.19-0.84; P = .03); there was a trend toward decreased risk of 30-day ED visits (RR, 0.61; CI, 0.37-1.37; P = .23). CONCLUSIONS AND IMPLICATIONS: This pilot study of an MIH transition care program was feasible with high protocol fidelity. It yields preliminary evidence demonstrating a decreased risk of rehospitalization in frail older adults.

Indexed as

Patient DischargePatient ReadmissionAgedAged, 80 and overAllied Health PersonnelFeasibility StudiesFemaleFrail ElderlyHumansMaleParamedicsPilot ProjectsTransitional CareCommunity paramedicineinformaticsmobile integrated healthpost-acute caretransitional care

Identifiers

PMID39030939
PMCPMC11486595

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

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.