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Int. J. Environ. Res. Public Health 2017, 14(5), 510;

What Type of Transitional Care Effectively Reduced Mortality and Improved ADL of Stroke Patients? A Meta-Analysis

School of Nursing, Hubei University of Chinese Medicine, Hong Shan District, Wuhan 430065, China
Department of Epidemiology and Biostatistics, and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
Research Support Center, Brigham Young University, Provo, UT 84602, USA
These two authors contributed equally to this work.
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 5 March 2017 / Revised: 17 April 2017 / Accepted: 28 April 2017 / Published: 10 May 2017
(This article belongs to the Section Global Health)
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Stroke is a major cause of disability and mortality worldwide; yet; prior to this study; there had been no sufficient evidence to support the effectiveness of various transitional care interventions (TCI) on the disability and mortality of stroke survivors. This meta-analysis aimed to assess the effectiveness of TCI in reducing mortality and improving the activities of daily life (ADL) of stroke patients. PubMed; Web of Science; OVID; EMBASE; CINAHL; and Sino-Med were searched for articles published before November 2016. Thirty-one randomized controlled trials (RCTs) were identified in the study. This analysis showed that the total effect of TCI on reducing mortality was limited (Risk Ratio (RR) = 0.86; 95% Confidence Interval (CI): 0.75–0.98); that only home-visiting programs could reduce mortality rates (RR = 0.34; 95% CI: 0.17–0.67) compared with usual care; and that the best intervention was led by a multidisciplinary team (MT) ≤3 months (RR = 0.19; 95% CI: 0.05–0.71). In addition; home-visiting programs also produced ADL benefit (RR = 0.56; 95% CI: 0.31–0.81). Overall; there was a statistically significant difference in improving patients’ independence between TCI and usual care (RR = 1.12; 95% CI: 1.02–1.23). However; none of the interventions was effective when they were differentiated in the analysis. It is the conclusion of this study that home-visiting programs; especially those led by MTs; should receive the greatest consideration by healthcare systems or providers for implementing TCI to stroke survivors. View Full-Text
Keywords: stroke; transitional care; interventions; mortality; ADL; meta-analysis stroke; transitional care; interventions; mortality; ADL; meta-analysis

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Wang, Y.; Yang, F.; Shi, H.; Yang, C.; Hu, H. What Type of Transitional Care Effectively Reduced Mortality and Improved ADL of Stroke Patients? A Meta-Analysis. Int. J. Environ. Res. Public Health 2017, 14, 510.

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