Evidence map›Paper›PMID 37591644›Full record

ArticleBMJ open2023

Evaluation of an integrated care pathway for out-of-hospital treatment of older adults with an acute moderate-to-severe lower respiratory tract infection or pneumonia: protocol of a mixed methods study.

Rick Roos, Rianne M C Pepping, Maarten O van Aken, Geert Labots, Ali Lahdidioui, Johanna M W van den Berg, Nikki E Kolfschoten, Sharif M Pasha, Joris T Ten Holder, Susan M Mollink and 6 more

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 38% of its field
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

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Article
  2. Moving forward, leaving the patients behind? A multilevel assessment framework for evaluating patient-centred, integrated care quality.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026
    Review
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

16 authors at 3 institutions in 1 country.

Rick RoosDepartment of Internal Medicine, Haga Teaching Hospital, The Hague, The Netherlands r.roos@hagaziekenhuis.nl.ORCID 0000-0002-7611-5301
Rianne M C PeppingDepartment of Internal Medicine, Haga Teaching Hospital, The Hague, The Netherlands.
Maarten O van AkenDepartment of Internal Medicine, Haga Teaching Hospital, The Hague, The Netherlands.
Geert LabotsDepartment of Internal Medicine, Haga Teaching Hospital, The Hague, The Netherlands.
Ali LahdidiouiDepartment of Internal Medicine, Haga Teaching Hospital, The Hague, The Netherlands.
Johanna M W van den BergDepartment of Pulmonology, Haga Teaching Hospital, The Hague, The Netherlands.
Nikki E KolfschotenDepartment of Emergency Medicine, Haga Teaching Hospital, The Hague, The Netherlands.
Sharif M PashaDepartment of Internal Medicine, Haaglanden Medical Center, The Hague, The Netherlands.
Joris T Ten HolderDepartment of Pulmonology, Haaglanden Medical Center, The Hague, The Netherlands.
Susan M MollinkDepartment of Emergency Medicine, Haaglanden Medical Center, The Hague, The Netherlands.
Frederiek van den BosDepartment of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands.
Jojanneke KantHadoks, The Hague, The Netherlands.
Ingrid KroonKroon Elderly Care Physician, The Hague, The Netherlands.
Rimke C VosHealth Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, The Netherlands.ORCID 0000-0003-1074-6255
Mattijs E NumansHealth Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, The Netherlands.
Cees van NieuwkoopDepartment of Internal Medicine, Haga Teaching Hospital, The Hague, The Netherlands.ORCID 0000-0003-0734-0844
Leiden University Medical Center · NLHaga Hospital · NLMedisch Centrum Haaglanden · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOlder adults with an acute moderate-to-severe lower respiratory tract infection (LRTI) or pneumonia are generally treated in hospitals causing risk of iatrogenic harm such as functional decline and delirium. These hospitalisations are often a consequence of poor collaboration between regional care partners, the lack of (acute) diagnostic and treatment possibilities in primary care, and the presence of financial barriers. We will evaluate the implementation of an integrated regional care pathway ('The Hague RTI Care Bridge') developed with the aim to treat and coordinate care for these patients outside the hospital. METHODS AND ANALYSIS: This is a prospective mixed methods study. Participants will be older adults (age≥65 years) with an acute moderate-to-severe LRTI or pneumonia treated outside the hospital (care pathway group) versus those treated in the hospital (control group). In addition, patients, their informal caregivers and treating physicians will be asked about their experiences with the care pathway. The primary outcome of this study will be the feasibility of the care pathway, which is defined as the percentage of patients treated outside the hospital, according to the care pathway, whom fully complete their treatment without the need for hospitalisation within 30 days of follow-up. Secondary outcomes include the safety of the care pathway (30-day mortality and occurrence of complications (readmissions, delirium, falls) within 30 days); the satisfaction, usability and acceptance of the care pathway; the total number of days of bedridden status or hospitalisation; sleep quantity and quality; functional outcomes and quality of life. ETHICS AND DISSEMINATION: The Medical Research Ethics Committee Leiden The Hague Delft (reference number N22.078) has confirmed that the Medical Research Involving Human Subjects Act does not apply to this study. The results will be published in international peer-reviewed journals. TRIAL REGISTRATION NUMBER: ISRCTN68786381.

Indexed as

DeliriumDelivery of Health Care, IntegratedPneumoniaRespiratory Tract InfectionsAgedCritical PathwaysHospitalsHumansProspective StudiesQuality of LifeAgingGERIATRIC MEDICINEPatient-Centered CarePatient ParticipationPatient SatisfactionPrimary Health Care

Identifiers

PMID37591644
PMCPMC10441079
OpenAlexW4385969483

What Socratic holds

Textmetadata
LicenceCC BY
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 Socratic graph.