Evidence map›Paper›PMID 39428539›Full record

Trial reportBMC medicine2024

Reducing rehospitalization in cardiac patients: a randomized, controlled trial of a cardiac care management program ("Cardiolotse") in Germany.

Wiebke Schüttig, Harald Darius, Katrin C Reber, Marie Coors, Amelie Flothow, Alfred Holzgreve, Sebastian Karmann, Anica Stürtz, Rebecca Zöller, Saskia Kropp and 2 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. 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

12 authors.

Wiebke SchüttigChair of Health Economics, TUM School of Medicine and Health, Technical University of Munich, Georg-Brauchle-Ring 60/62, Munich, 80992, Germany. wiebke.schuettig@tum.de.
Harald DariusVivantes - Netzwerk für Gesundheit GmbH, Berlin, Germany.
Katrin C ReberAOK Nordost - Die Gesundheitskasse, Health Services Management, Berlin, Germany.
Marie CoorsChair of Health Economics, TUM School of Medicine and Health, Technical University of Munich, Georg-Brauchle-Ring 60/62, Munich, 80992, Germany.
Amelie FlothowChair of Health Economics, TUM School of Medicine and Health, Technical University of Munich, Georg-Brauchle-Ring 60/62, Munich, 80992, Germany.
Alfred HolzgreveVivantes - Netzwerk für Gesundheit GmbH, Berlin, Germany.
Sebastian KarmannVivantes - Netzwerk für Gesundheit GmbH, Berlin, Germany.
Anica StürtzAOK Nordost - Die Gesundheitskasse, Health Services Management, Berlin, Germany.
Rebecca ZöllerAOK Nordost - Die Gesundheitskasse, Health Services Management, Berlin, Germany.
Saskia KroppChair of Health Economics, TUM School of Medicine and Health, Technical University of Munich, Georg-Brauchle-Ring 60/62, Munich, 80992, Germany.
Petra RiesnerAOK Nordost - Die Gesundheitskasse, Health Services Management, Berlin, Germany.
Leonie SundmacherChair of Health Economics, TUM School of Medicine and Health, Technical University of Munich, Georg-Brauchle-Ring 60/62, Munich, 80992, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe conducted a prospective, randomized, controlled, two-group parallel trial investigating the effectiveness of a care management program employing cardiac care navigators providing post-discharge support to patients compared to standard care.

methodsThe intervention commenced in 2019/2020 for 2862 patients hospitalized with heart failure, coronary heart disease, or cardiac arrhythmias in departments of cardiology across eight participating sites of a hospital group in Berlin, Germany. We analyzed the results using an intention-to-treat approach. The primary outcome was the all-cause rehospitalization rate after 12 months. Secondary outcomes included rehospitalizations due to one of the qualifying cardiac diagnoses, duration of rehospitalization, mortality, health-related quality of life, and several process indicators. Trial data were collected from a combination of face-to-face and phone interviews conducted by hospital staff throughout the 12-month follow-up period using standardized questionnaires. Administrative claims data were provided by a large statutory health insurer. Outcomes for the intervention and control groups were compared using logistic regression, generalized linear models (GLMs) with a negative binomial distribution, ordinary least squares, and Cox proportional hazards regression.

resultsCompared to the control group (N = 1294), the intervention group (N = 1256) had a lower rate of all-cause rehospitalizations (62.6% vs. 66.4%, p = 0.05) and shorter lengths of stay (14.49 vs. 16.89 days, p = 0.02) during the 12-month follow-up period. These differences were also present for rehospitalizations due to the cardiac diseases qualifying for study recruitment, with rehospitalization rates for the intervention and control groups being 58.0% vs. 61.4% (p = 0.08) and particularly pronounced for lengths of rehospitalization stay of 12.97 vs. 15.40 days (p = 0.01), respectively. Subgroup analyses indicated positive effects of the intervention for patients 70 years and older (p = 0.05), females (p = 0.06), and those with little or no German language proficiency (p = 0.03). Furthermore, we found positive effects on patients' adherence to health-related behavioral recommendations (81.91% vs. 73.95%, p = 0.000).

conclusionsThis study adds to the body of evidence indicating that care management interventions supporting patients as they transition from the inpatient to the outpatient sector can lower rehospitalizations, decrease length of rehospitalization stays, and improve adherence to post-discharge recommendations.

trial registrationGerman Clinical Trial Register, DRKS00020424 . Registered 2020-06-18. (retrospectively registered).

Indexed as

Patient ReadmissionAgedAged, 80 and overFemaleGermanyHumansMaleMiddle AgedProspective StudiesQuality of LifeAdherenceCardiovascular diseaseCare managementDischargeHospitalizationSocioeconomics

Identifiers

PMID39428539
PMCPMC11492482

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.