Preparing Patients and Caregivers to Participate in Care Delivered Across Settings: The Care Transitions Intervention.

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Preparing Patients and Caregivers to Participate in Care Delivered Across Settings: The Care Transitions Intervention.

Coleman EA, Smith JD, Frank JC, et al. J Am Geriatr Soc.Preparing Patients and Caregivers to Participate in Care Delivered Across Settings: The Care Transitions Intervention. J Am Geriatr Soc. 2004;52(11):1817-1825. http://www.caretransitions.org/documents/Preparing%20patients%20-%20JAGS.pdf . Accessed August 7, 2014. RESULTS: The adjusted odds ratio comparing rehospitalization of intervention subjects with that of controls was 0.52 (95% confidence interval (CI)50.28–0.96) at 30 days, 0.43 (95% CI50.25–0.72) at 90 days, and 0.57 (95% CI50.36–0.92) at 180 days. Intervention patients reported high levels of confidence in obtaining essential information for managing their condition, communicating with members of the healthcare team, and understanding their medication regimen. CONCLUSION: Supporting patients and caregivers to take a more active role during care transitions appears promising for reducing rates of subsequent hospitalization. Further testing may include more diverse populations and patients at risk for transitions who are not acutely ill.

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