Bmc Health Serv Res
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Bmc Health Serv Res · Mar 2013
Randomized Controlled TrialImpact of telemonitoring home care patients with heart failure or chronic lung disease from primary care on healthcare resource use (the TELBIL study randomised controlled trial).
There is growing evidence that home telemonitoring can be advantageous in societies with increasing prevalence of chronic diseases.The main objective of this study is to evaluate the effect of a primary care-based telemonitoring intervention on the number and length of hospital admissions. ⋯ This study shows that telemonitoring of in-home patients with HF and/or CLD notably increases the percentage of patients with no hospital admissions and indicates a trend to reduce total and cause-specific hospitalisations and hospital stay. Home telemonitoring can constitute a beneficial alternative mode of healthcare provision for medically unstable elderly patients.
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Bmc Health Serv Res · Jan 2013
Randomized Controlled TrialText-messaging versus telephone reminders to reduce missed appointments in an academic primary care clinic: a randomized controlled trial.
Telephone or text-message reminders have been shown to significantly reduce the rate of missed appointments in different medical settings. Since text-messaging is less resource-demanding, we tested the hypothesis that text-message reminders would be as effective as telephone reminders in an academic primary care clinic. ⋯ Text-message reminders are equivalent to telephone reminders in reducing the proportion of missed appointments in an academic primary care clinic and are more cost-effective. Both types of reminders are well accepted by patients.
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Bmc Health Serv Res · Jan 2013
Randomized Controlled TrialFacilitated patient experience feedback can improve nursing care: a pilot study for a phase III cluster randomised controlled trial.
England's extensive NHS patient survey programme has not fulfilled government promises of widespread improvements in patients' experiences, and media reports of poor nursing care in NHS hospitals are increasingly common. Impediments to the surveys' impact on the quality of nursing care may include: the fact that they are not ward-specific, so nurses claim "that doesn't happen on my ward"; nurses' scepticism about the relevance of patient feedback to their practice; and lack of prompt communication of results. The surveys' impact could be increased by: conducting ward-specific surveys; returning results to ward staff more quickly; including patients' written comments in reports; and offering nurses an opportunity to discuss the feedback. Very few randomised trials have been conducted to test the effectiveness of patient feedback on quality improvement and there have been few, if any, published trials of ward-specific patient surveys. ⋯ This study provides preliminary evidence that facilitated patient feedback can improve patients' experiences such that a full trial is justified. These findings suggest that merely informing nurses of patient survey results in writing does not stimulate improvements, even if results are disaggregated by ward, but the addition of ward meetings had an important and significant impact.
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Bmc Health Serv Res · Jan 2013
Randomized Controlled TrialImplementation and effectiveness of 'care navigation', coordinated management for people with complex chronic illness: rationale and methods of a randomised controlled trial.
Chronic illness is a significant driver of the global burden of disease and associated health care costs. People living with severe chronic illness are heavy users of acute hospital services; better coordination of their care could potentially improve health outcomes while reducing hospital use. The Care Navigation trial will evaluate an in-hospital coordinated care intervention on health service use and quality of life in chronically ill patients. ⋯ A trial of in-hospital care coordination may support recent evidence that engaging primary health services in care plans linked to multidisciplinary team support improves patient outcomes and reduces costs to the health system. This will inform local, national and international health policy.
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Bmc Health Serv Res · Jan 2013
Randomized Controlled Trial Multicenter StudyA multicentre, double-blind, randomised, controlled, parallel-group study of the effectiveness of a pharmacist-acquired medication history in an emergency department.
Admission to an emergency department (ED) is a key vulnerable moment when patients are at increased risk of medication discrepancies and medication histories are an effective way of ensuring that fewer errors are made. This study measured whether a pharmacist-acquired medication history in an ED focusing on a patient's current home medication regimen, and available to be used by a doctor when consulting in the ED, would reduce the number of patients having at least 1 medication discrepancy related to home medication. ⋯ A pharmacist-acquired medication history in an ED focusing on a patient's current home medication regimen available to be used by a doctor at the time of consulting in the ED reduced the number of patients having at least 1 home medication-related discrepancy.