Tibaldi 2009.
| Study characteristics | ||
| Methods | Parallel randomised trial Study conducted between April 2004 and April 2005. |
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| Participants | Setting: Italy People with acute decompensation of chronic heart failure recruited within 12 to 24 hours of admission to the emergency department. Care supervision possible at home, telephone at home, need for IV infusions, living in catchment area, at least 1 previous admission for chronic heart failure Age: 75 years and over, mean age 81 Number recruited: hospital at home: 48; hospital: 53 |
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| Interventions | Admission avoidance hospital at home, hospital outreach (hospital maintains legal and financial responsibility); 24‐hour care available 7 days a week; 4 specialist geriatricians, home care nurses, physiotherapist, social worker, counsellor, IV infusions available. Control group: admission to San Giovanni Battista Hospital, Turin, Italy |
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| Outcomes | Mortality, readmission, length of stay, residential care, health status, psychological well‐being | |
| Notes | Funding: not reported Conflicts of interest: none reported Ethical approval: hospital ethics committee |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Computer‐generated random sequence |
| Allocation concealment (selection bias) | Low risk | Numbered, sealed envelopes |
| Baseline outcome measurements (selection bias) | Low risk | Baseline outcome measurements done prior to intervention for health status and psychological well‐being; no relevant differences found |
| Baseline characteristics (selection bias) | Low risk | Baseline characteristics of the study and control groups are reported and are similar |
| Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Blinding of participants and personnel not possible |
| Blinding of outcome assessment (detection bias) Subjective outcomes | Low risk | Outcomes assessed by a postgraduate doctor not involved with delivery of health care, and blinded to the study allocation |
| Blinding of outcome assessment (detection bias) Objective outcomes | Low risk | Outcomes assessed by a postgraduate doctor not involved with delivery of health care, and blinded to the study allocation |
| Incomplete outcome data (attrition bias) All outcomes | Unclear risk | 4% loss to follow‐up |
| Selective reporting (reporting bias) | Low risk | Standard set of outcomes reported |