Effects of alternative interventions among hospitalized, cognitively impaired older adults

Abstract

Aim: Compare within site effects of three interventions designed to enhance outcomes of hospitalized cognitively impaired elders.

Methods: Prospective, nonrandomized, confirmatory phased study. In Phase I, 183 patients received one of three interventions: augmented standard care (ASC), resource nurse care (RNC) or Transitional Care Model (TCM). In Phase II, 205 patients received the TCM.

Results: Time to first rehospitalization or death was longer for the TCM versus ASC group (p = 0.017). Rates for total all-cause rehospitalizations and days were significantly reduced in the TCM versus ASC group (p < 0.001, both). No differences were observed between RNC versus TCM.

Conclusion: Findings suggest the TCM is more effective than ASC. However, potential effects of the RNC relative to the TCM warrant further study.

Keywords: cognitive impairment; dementia; evidence-based interventions; rehospitalizations.

Conflict of interest statement

Financial & competing interests disclosure This work was funded by the National Institute on Aging [Grant Number: R01 AG023116]; and the Marian S Ware Alzheimer's Program at the University of Pennsylvania. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.

Figures

Figure 1.. Kaplan–Meier curve of sites A, B and C.

ASC: Augmented standard care; RNC: Resource nurse care; TCM: Transitional Care Model.

Figure 2.. Rehospitalizations and days rehospitalized over time by phase and site.

(A) Rehospitalizations over time by phase by site. (B) Total days hospitalized over time by phase by site. ASC: Augmented standard care; Ph: Phase; RNC: Resource nurse care; S: Site; TCM: Transitional Care Model.