Christine S. Ritchie|Thomas K. Houston|Joshua Richman|Heather J. Sobko|Eta S. Berner|Benjamin Taylor|Amanda H. Salanitro|Julie L. Locher
The E-Coach technology-assisted care transition system: a pragmatic randomized trial
University of Alabama at Birmingham|University of California, San Francisco|Quality Enhancement Research Initiative|Edith Nourse Rogers Memorial Veterans Hospital|University of Massachusetts Chan Medical School|Birmingham VA Medical Center|Southern Research Institute|VA Tennessee Valley Healthcare System|Geriatric Research Education and Clinical Center|Vanderbilt University|Alabama Department of Public Health
care transitions hospital home remain vulnerable time many patients especially heart failure chf chronic obstructive pulmonary disease copd despite regular use chronic disease management remains unclear technology best support patients transition hospital sought evaluate impact technologysupported care transition support program hospitalizations days community mortality using pragmatic randomized trial enrolled patients 511 enrolled 478 analyzed hospitalized chfcopd ecoach intervention conditionspecific customization inhospital postdischarge support care transition nurse ctn interactive voice response postdischarge calls ctn followup versus usual postdischarge care uc primary outcome 30day rehospitalization secondary outcomes included 1 rehospitalization death 2 days hospital community ecoach uc groups similar baseline except gender imbalance p 002 adjustment gender primary outcome 30day rehospitalization rates differ ecoach uc groups 150 vs 163 adjusted hazard ratio 95 confidence interval 094 060 149 however copd subgroup ecoach associated significantly fewer days hospital 05 vs 16 p 003 ecoach ivraugmented care transition intervention reduce rehospitalization positive impact secondary outcome days hospital among copd patients chf may suggest ecoach may beneficial among patients copd nih trial registry number nct01135381 trial protocol httpdxdoiorg101016jcct201208007