Effects of hospital-to-home transitional care on health outcomes of elderly patients: a randomized controlled trial, Islamic Republic of Iran

Background: Hospitalization has a negative effect on the functional and clinical outcomes of elderly patients. Aims: To evaluate the effect of a care transition intervention on functional and clinical outcomes and quality of life of elderly Iranian patients after hospital discharge in a 3-month follow-up. Methods: We conducted a randomized controlled trial of 304 elderly hospitalized patients in Tehran from December 2018 to January 2020 (IRCT20180213038710N1). The intervention group (n = 152) received the care transition intervention; the control group (n = 152) received the routine hospital discharge programme. All patients were assessed during hospital stay, and 30, 60 and 90 days after hospital discharge. Participants were evaluated using the Minimum Data Set–Home Care form which assesses: activity of daily living; instrumental activity of daily living; cognitive performance; cognition; pain; and depression rating. Rehospitalization and quality of life were also evaluated. Differences between the groups and trends in quality of life were assessed. Results: Only instrumental activity of daily living in functional outcomes and quality of life were greater the intervention group compared with controls. The intervention (odds ratio (OR): 0.11; 95% confidence intervals (CI): 0.01–0.97), age (OR: 1.16; 95% CI: 1.01–1.33) and cognition (OR: 1.24; 95% CI: 1.02–1.51) predicted instrumental activity of daily living. Age (coefficient: –0.009, P = 0.001), depression (coefficient: –0.157; P < 0.001), cognition (coefficient: –0.023, P < 0.001) and pain (coefficient: –0.106, P = 0.007) predicted quality of life. Conclusion: Care transition interventions can help maintain the independence of older adults after hospital discharge and improve their quality of life.