Jerant 2001.

Methods	DETAILS OF STUDY AIM OF INTERVENTION: to reduce readmissions. AIM OF STUDY: To compare the effectiveness of 3 hospital discharge care models for reduction congestive heart failure related readmission charges: 1/ home telecare delivered via a 2‐way video‐conference device with an integrated electronic stethoscope; 2/ nurse telephone calls; and 3/ usual outpatient care. STUDY DESIGN: RCT. METHODS OF RECRUITMENT OF PARTICIPANTS: During a one year period all patients with a primary admission diagnosis of chronic heart failure were screened on the inclusion criteria. Patients who agreed to participate were randomized before discharge, to one of 3 models, using sealed envelopes. INCLUSION CRITERIA FOR PARTICIPATION IN STUDY: CHF/ aged 40 and older/ telephone at home/ English speaking/ area university of California/ adequate vision and hearing. EXCLUSION CRITERIA FOR PARTICIPATION IN STUDY: to much comorbidity (Charlson score >6), Geriatric depression score >7, Mini mental state<20, symbol digit modalities test low. INFORMED CONSENT OBTAINED? yes. ETHICAL APPROVAL? yes. FUNDING: yes. ASSESSMENT OF STUDY QUALITY ALLOCATION CONCEALMENT: adequate. EPOC‐ QUALITY CRITERIA 2002: B. moderate risk of bias. METHOD OF GENERATING RANDOMISATION SCHEDULE:random number assignment and using opaque envelopes. METHOD OF CONCEALMENT OF ALLOCATION: opaque envelopes. BLINDING: ·PARTICIPANTS: no. ·PROVIDER/S: no. ·OUTCOME ASSESSOR/S: no. INTENTION TO TREAT ANALYSIS: yes. BASELINE COMPARABILITY OF INTERVENTION AND CONTROL GROUPS: yes. STATISTICAL METHODS AND THEIR APPROPRIATENESS: chi‐square/anova. CONSUMER INVOLVEMENT: not stated.
Participants	DESCRIPTION: cardiac patients. GEOGRAPHIC LOCATION: USA. SETTING: discharged home from an acute care setting. NUMBER OF PARTICIPANTS: ELIGIBLE: 37. RANDOMISED TO INTERVENTION: 12. RANDOMISED TO CONTROL: 13 ‐ 12. INCLUDED IN ANALYSIS INTERVENTION GROUP: 11. INCLUDED IN ANALYSIS CONTROL GROUP: 13 ‐ 12 AGE: RANGE OR MEAN (SD): 68 (12) GENDER (% MALE) 45 ETHNICITY 48% white PRINCIPAL HEALTH PROBLEM OR DIAGNOSIS: congestive heart failure OTHER HEALTH PROBLEM/S: 70% high functional impairment TREATMENT RECEIVED/RECEIVING: medication OTHER SOCIAL/DEMOGRAPHIC DETAILS:
Interventions	DETAILS OF INTERVENTION: All 3 groups received home visit of a nurse shortly after discharge and at day 60. Patient in telephone group received scheduled phone calls from nurse, whereas patients of the telecare group received scheduled telecare visits. Both groups also had possibility to contact study nurse. Difference between the intervention groups is that the telecare group could also see and not only hear study nurse, and vice versa. During contacts several health status measures were filled out. DETAILS OF CONTROL: The telecare was instructed in the use of the equipment and received home telecare visits/ Patients in the usual care group received 2 home visits. CO‐INTERVENTION? yes. DETAILS OF CO‐INTERVENTIONS: all patients received an in‐person home nurse visit shortly after discharge and second in‐person home nurse visit 60 days later. During both visits completed some questionnaires. DELIVERY OF INTERVENTION Frequency: 6. First time at day unclear after discharge. Period: 8 weeks. PROVIDERS: nurse. INTERVENTION QUALITY: good. FIDELITY/INTEGRITY: good.
Outcomes	NUMBER OF OUTCOMES: 3 OUTCOME / TOOL / TOOL VALIDATED / METHOD OF ASSESSMENT / TIME OF ASSESSMENT A.Psycho‐social health of patients (uncertainty, anxiety, informational needs, mood, coping, quality of life, social activity, ..): Satisfaction / Client Satisfaction questionnaire (Attkisson, 1982) / yes / interview / 60 days. Mental status / SF‐36 (Ware, 1992), Minnesota Living wit Heart Failure Questionnaire (Rector, 1992) / yes / interview / 60 days after discharge. B.Physical health of patients (eg. functional status, self‐care, self‐efficacy, independence, ..): Physical status / SF‐36 (Ware, 1992), Minnesota Living wit Heart Failure Questionnaire (Rector, 1992) / yes / interview / 60 days after discharge. C.Other consumer oriented outcomes (eg. treatment adherence, knowledge, adverse events, ..): D. Health service delivery oriented outcomes (eg. hospital readmission, health services utilization, ..):
Notes	·CHANGES IN TRIAL PROTOCOL: readmissions/ed‐visits and charges were also measured but only at 6 months, which is outside the scope of this review. ·CONTACT WITH AUTHOR: yes. ·POWER CALCULATION? yes. ·RECORD IF THE STUDY WAS TRANSLATED FROM A LANGUAGE OTHER THAN ENGLISH. ·RECORD IF THE STUDY WAS A DUPLICATE PUBLICATION. Yes, see Jerant 2003.
Risk of bias
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Low risk	A ‐ Adequate