Abstract:
BACKGROUND:Nearly 25% of patients hospitalized with heart failure (HF) are readmitted within 30 days. PURPOSE:To assess the efficacy, comparative effectiveness, and harms of transitional care interventions to reduce readmission and mortality rates for adults hospitalized with HF. DATA SOURCES:MEDLINE, Cochrane Library, CINAHL, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform (1 January 1990 to late October 2013). STUDY SELECTION:Two reviewers independently selected randomized, controlled trials published in English reporting a readmission or mortality rate within 6 months of an index hospitalization. DATA EXTRACTION:One reviewer extracted data, and another checked accuracy. Two reviewers assessed risk of bias and graded strength of evidence (SOE). DATA SYNTHESIS:Forty-seven trials were included. Most enrolled adults with moderate to severe HF and a mean age of 70 years. Few trials reported 30-day readmission rates. At 30 days, a high-intensity home-visiting program reduced all-cause readmission and the composite end point (all-cause readmission or death; low SOE). Over 3 to 6 months, home-visiting programs and multidisciplinary heart failure (MDS-HF) clinic interventions reduced all-cause readmission (high SOE). Home-visiting programs reduced HF-specific readmission and the composite end point (moderate SOE). Structured telephone support (STS) interventions reduced HF-specific readmission (high SOE) but not all-cause readmissions (moderate SOE). Home-visiting programs, MDS-HF clinics, and STS interventions produced a mortality benefit. Neither telemonitoring nor primarily educational interventions reduced readmission or mortality rates. LIMITATIONS:Few trials reported 30-day readmission rates. Usual care was heterogeneous and sometimes not adequately described. CONCLUSION:Home-visiting programs and MDS-HF clinics reduced all-cause readmission and mortality; STS reduced HF-specific readmission and mortality. These interventions should receive the greatest consideration by systems or providers seeking to implement transitional care interventions for persons with HF. PRIMARY FUNDING SOURCE:Agency for Healthcare Research and Quality.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Feltner C,Jones CD,Cené CW,Zheng ZJ,Sueta CA,Coker-Schwimmer EJ,Arvanitis M,Lohr KN,Middleton JC,Jonas DEdoi
10.7326/M14-0083subject
Has Abstractpub_date
2014-06-03 00:00:00pages
774-84issue
11eissn
0003-4819issn
1539-3704pii
1874735journal_volume
160pub_type
杂志文章,meta分析,评审abstract::The coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a series of workshops during whi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-150-7-200904070-00115
更新日期:2009-04-07 00:00:00
abstract::Subacute encephalitis caused by infection of the central nervous system by the human immunodeficiency virus (HIV) is the most frequent cause of neurologic dysfunction in patients with the acquired immunodeficiency syndrome (AIDS). This disorder results in progressive cognitive, motor, and behavioral abnormalities in a...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-107-2-383
更新日期:1987-09-01 00:00:00
abstract::A 20-year follow-up evaluation of young men with fixed and reproducible orthostatic proteinuria showed no evidence of progressive renal disease. Follow-up information was obtained on 43 of the original 64 patients and detailed information was secured on 36. All had normal renal function and only six patients continued...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-97-4-516
更新日期:1982-10-01 00:00:00
abstract::Arteriohepatic dysplasia (Alagille's syndrome) is presumed to be one of the familial intrahepatic cholestatic syndromes, all of which present with neonatal jaundice or failure to thrive, or both. We report the findings in five patients with this syndrome, four of whom have been followed into adulthood. In addition to ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-91-4-520
更新日期:1979-10-01 00:00:00
abstract:BACKGROUND:Rheumatoid arthritis is associated with increased morbidity and mortality because of cardiovascular disease, independent of traditional risk factors. OBJECTIVE:To determine the prevalence of preclinical atherosclerosis in patients with rheumatoid arthritis and to identify clinical and biological markers for...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-144-4-200602210-00006
更新日期:2006-02-21 00:00:00
abstract:Background:In 1994, 40% of U.S. gun owners who had recently acquired a firearm did so without a background check. No contemporary estimates exist. Objective:To estimate the proportion of current U.S. gun owners who acquired their most recent firearm without a background check, by time since and manner of acquisition, ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M16-1590
更新日期:2017-02-21 00:00:00
abstract:OBJECTIVE:To determine whether a cytogenetic response after interferon-alpha therapy in patients with chronic myelogenous leukemia is independently associated with improved survival. DESIGN:Retrospective analysis. PATIENTS:274 patients with a diagnosis of Philadelphia chromosome-positive chronic myelogenous leukemia ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-122-4-199502150-00003
更新日期:1995-02-15 00:00:00
abstract:BACKGROUND:Homeless persons have high mortality rates. OBJECTIVE:To ascertain causes of death in a group of homeless persons. DESIGN:Cohort study. PATIENTS:17,292 adults seen by the Boston Health Care for the Homeless Program from 1988 to 1993. MEASUREMENTS:Cause-specific mortality rates adjusted for race and rate ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-126-8-199704150-00007
更新日期:1997-04-15 00:00:00
abstract::The data from population-based, randomized trials of the mammographic screening of women aged 40 to 49 years are limited by retrospective subgroup analysis, low statistical power, and the use of older mammographic techniques. Nonetheless, meta-analysis involving the most recently reported data from all similarly desig...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-122-7-199504010-00010
更新日期:1995-04-01 00:00:00
abstract::In a prospective study, mortality ratios were computed in relation to overweight, cancer, and other diseases. The study included 750 000 men and women followed for 12 years. Each person was given a weight index. Death rates for overweight and underweight persons were compared with rates for persons of average weight. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-103-6-1034
更新日期:1985-12-01 00:00:00
abstract::Concierge medical practices, which advertise expanded access to care and individualized attention, collect charges both from insurance companies and directly from their patients. Some bill hundreds of dollars for one-time "executive" physicals, whereas others have patients pay annual retainer fees. Yet, virtually no d...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-152-6-201003160-00009
更新日期:2010-03-16 00:00:00
abstract::Essential trace elements such as zinc, iron, and copper participate in various enzyme reactions directly related to the regulation of blood pressure and indirectly related to generation of oxidative metabolic energy, alterations in blood lipid levels, and alterations in taste acuity. The toxicological action of severa...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-98-5-823
更新日期:1983-05-01 00:00:00
abstract:BACKGROUND:Corticosteroid injections (CSIs) and physical therapy are used to treat patients with the shoulder impingement syndrome (SIS) but have never been directly compared. OBJECTIVE:To compare the effectiveness of 2 common nonsurgical treatments for SIS. DESIGN:Randomized, single-blind, comparative-effectiveness,...
journal_title:Annals of internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.7326/M13-2199
更新日期:2014-08-05 00:00:00
abstract:STUDY OBJECTIVE:To assess the long-term benefit and side effects of danazol therapy, and to delineate factors influencing the responses in patients with autoimmune thrombocytopenia. DESIGN:Before and after trial. SETTING:Referral-based hematology clinics and the University of Miami teaching hospitals. PATIENTS:Data ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-111-9-723
更新日期:1989-11-01 00:00:00
abstract::Expert groups, including the U.S. Preventive Services Task Force (USPSTF), recommend a range of clinical preventive services for persons at average risk for disease. Use of these services often is substantially lower among racial and ethnic minority groups, rural residents, and persons of lower socioeconomic status. O...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M19-3171
更新日期:2020-02-18 00:00:00
abstract:BACKGROUND:Home-based primary care for homebound seniors is complex, and practice constraints are unique. No quality-of-care standards exist. OBJECTIVE:To identify process quality indicators that are essential to high-quality, home-based primary care. DESIGN:An expert development panel reviewed established and new qu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-146-3-200702060-00008
更新日期:2007-02-06 00:00:00
abstract:PURPOSE:To compare the efficacy, safety, and cost-effectiveness of low-molecular-weight heparin with standard heparin for the prevention of deep vein thrombosis after total hip arthroplasty. DATA IDENTIFICATION:Studies were identified by MEDLINE search and review of bibliographies of retrieved articles. Hospital resou...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-119-11-199312010-00008
更新日期:1993-12-01 00:00:00
abstract:OBJECTIVE:To compare trimethoprim-sulfamethoxazole (TMP-SMZ) and vancomycin regarding efficacy and safety in the therapy of serious Staphylococcus aureus infections. DESIGN:Randomized, double-blind comparative trial. SETTING:A tertiary-care hospital. PATIENTS:One hundred and one intravenous drug users hospitalized w...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-117-5-390
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:Previous studies suggest that patients hospitalized with acute myocardial infarction (MI) in December have poor outcomes, and some studies have hypothesized that the cause may be the infrequent use of evidence-based therapies during the December holiday season. OBJECTIVE:To compare the care and outcomes of ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-143-7-200510040-00006
更新日期:2005-10-04 00:00:00
abstract::Medically unexplained functional or somatization symptoms are somatic disorders that are not adequately explained by physical disease processes. The way in which these disorders have been understood and managed has varied over the history of medicine. However, only in the past 100 years has the "mental" explanation pr...
journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章,评审
doi:10.7326/0003-4819-134-9_part_2-200105011-00018
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Screening for hereditary hemochromatosis is traditionally done by using serum iron studies. However, mutation analysis of the hemochromatosis-associated HFE gene has recently become available. OBJECTIVE:To compare the cost-effectiveness of no screening with four screening strategies that incorporate HFE gen...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-132-4-200002150-00003
更新日期:2000-02-15 00:00:00
abstract::Eighteen episodes of community-acquired bacterial pneumonia were diagnosed in 13 patients among 336 with the acquired immunodeficiency syndrome (AIDS) cared for at Memorial Sloan-Kettering Cancer Center since 1979. Bacterial pathogens isolated in 16 of 18 episodes were Haemophilus influenzae in 8, Streptococcus pneumo...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-104-1-38
更新日期:1986-01-01 00:00:00
abstract::A retrospective analysis of the course of systemic lupus erythematosus in pregnant patients hospitalized at UCLA during a 15-year period provided important prognostic information. Women with systemic lupus erythematosus became pregnant if renal function was reasonably well preserved. Pregnancy infrequently posed a ser...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-94-5-667
更新日期:1981-05-01 00:00:00
abstract::We report the case of a 23-year-old woman who developed severe myalgias in association with mild hepatitis B surface antigen-positive hepatitis. Muscle biopsy showed myriads of microvacuoles filled with neutral lipid. Prednisone therapy was associated with complete clearing of all clinical and laboratory abnormalities...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-87-4-417
更新日期:1977-10-01 00:00:00
abstract::Questionnaire II of the National Study of Internal Medicine Manpower was directed to all of the 1502 subspecialty training programs in the United States and Puerto Rico. The overall response rate was 86%. For the years 1972-1973 through 1976-1977 the number of fellows in subspecialty training grew at an average rate o...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-91-2-287
更新日期:1979-08-01 00:00:00
abstract:OBJECTIVE:To determine whether the detection of tuberculostearic acid (TBSA) in bronchial aspirate and bronchoalveolar lavage specimens is useful for the rapid diagnosis of active pulmonary tuberculosis in patients suspected of having the disease. SETTING:A pulmonary clinic in a teaching hospital. PATIENTS:Forty pati...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-111-8-650
更新日期:1989-10-15 00:00:00
abstract::The prevalence of active tuberculosis and positive tuberculin skin tests was assessed in 132 corticosteroid-treated asthmatics for an evaluation period that represented 620 corticosteroid-years of therapy. There was no evidence of active tuberculosis in any of these patients. Positive intermediate-strength tuberculin ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-84-3-261
更新日期:1976-03-01 00:00:00
abstract:BACKGROUND:Screening women for Chlamydia trachomatis in family planning clinics is associated with a reduced incidence of chlamydial sequelae. However, the question of whom to screen to maintain efficient use of resources remains controversial. OBJECTIVE:To assess the cost-effectiveness of chlamydial screening done ac...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-128-4-199802150-00005
更新日期:1998-02-15 00:00:00
abstract:BACKGROUND:Prediction of perioperative cardiac complications is important in the medical management of patients undergoing noncardiac surgery. Several indices have been developed to aid prediction, but their performance has not been systematically compared. OBJECTIVE:To compare four existing methods for predicting per...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-133-5-200009050-00011
更新日期:2000-09-05 00:00:00
abstract::Molecular analysis of normal and abnormal human globin genes and their gene products has recently provided information on the precise genetic events that result in hemoglobinopathies. In the case of structurally abnormal hemoglobins, the following mechanisms can be invoked: single nucleotide base substitutions leading...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-91-4-605
更新日期:1979-10-01 00:00:00