Agency News and Notes

Evidence lacking on transition-of-care programs for heart attack and stroke patients after hospital discharge

There are few studies that support the adoption of any specific transition-of-care program as a matter of health policy, according to a new Agency for Healthcare Research and Quality (AHRQ) report on transition-of-care services for stroke and heart attack patients after hospital discharge. Despite advances in the quality of acute-care management of stroke and heart attacks, there are gaps in knowledge about effective programs that improve the post-hospitalization quality of care for these patients.

Researchers at the AHRQ-supported Duke Evidence-based Practice Center conducted the evidence review of transition-of-care programs for heart attack and stroke patients and found no interventions that consistently improved functional recovery after stroke or heart attack. None seemed to consistently improve quality of life or factors such as anxiety or depression, according to the report. Led by DaiWai M. Olson, Ph.D., researchers found that some components of care transition, such as early supported discharge from the hospital with rehabilitation at home following stroke, appear to shorten the length of hospital stay without increased death rates or adverse effects on functional recovery. Additionally, specialty care followup after a heart attack was associated with reduced mortality. Researchers noted that additional research is needed before any conclusion can be reached that a specific care transition approach is effective and worthy of widespread adoption.

A copy of the report, Transition of Care for Acute Stroke and Myocardial Infarction Patients: From Hospitalization to Rehabilitation, Recovery, and Secondary Prevention, is available online at http://effectivehealthcare.ahrq.gov.

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