Skip to main content
Top
Published in: Arthritis Research & Therapy 1/2018

Open Access 01-12-2018 | Research article

Effects of transitional care on self-care, readmission rates, and quality of life in adult patients with systemic lupus erythematosus: a randomized controlled trial

Authors: Xia Xie, Yuqing Song, Hui Yang, Anliu Nie, Hong Chen, Ji-ping Li

Published in: Arthritis Research & Therapy | Issue 1/2018

Login to get access

Abstract

Background

Lack of adequate self-care, frequent admissions, and poor quality of life are common and serious problems in adult patients with systemic lupus erythematosus (SLE). Some studies have revealed that transitional care is effective in improving self-care and quality of life as well as reducing rehospitalization rates. However, limited studies explored its effects in adult patients with SLE. Therefore, we performed a study to examine the effects of transitional care on self-care, readmission rates, and quality of life in adult patients with SLE.

Methods

This study was a single-center, single-blind, and parallel-group randomized controlled trial comparing transitional care with usual care in SLE patients from a university hospital in China. Evaluations were conducted at baseline before discharge and at 3 months after discharge by using hospital readmission rate, the Exercise of Self-Care Agency Scale, and the Medical Outcomes Study Short Form 36-item Health Survey for self-care and quality of life. Data were collected between June and December 2016.

Results

Compared with the usual care group, the transitional care group reported significantly greater improvement in self-care and quality of life. Additionally, the 30-day readmission rate for the patients in the transitional care group was significantly lower than in the usual care group, and this effect remained significant at 60 and 90 days after patient discharge.

Conclusion

This study shows that transitional care improves self-care and quality of life in adult patients with SLE and reduces readmissions. However, further studies are needed.

Trial registration

China clinical trial registry, ChiCTR-IPR-16007708. Registered January 5, 2016.
Appendix
Available only for authorised users
Literature
1.
go back to reference Rees F, Doherty M, Grainge M, Davenport G, Lanyon P, Zhang W. The incidence and prevalence of systemic lupus erythematosus in the UK, 1999-2012. Ann Rheum Dis. 2016;75:136–41. Rees F, Doherty M, Grainge M, Davenport G, Lanyon P, Zhang W. The incidence and prevalence of systemic lupus erythematosus in the UK, 1999-2012. Ann Rheum Dis. 2016;75:136–41.
2.
go back to reference Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: part I. Arthritis Rheum. 2008;58:15–25.CrossRefPubMed Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: part I. Arthritis Rheum. 2008;58:15–25.CrossRefPubMed
3.
go back to reference Yeh KW, Yu CH, Chan PC, Horng JT, Huang JL. Burden of systemic lupus erythematosus in Taiwan: a population-based survey. Rheumatol Int. 2013;33:1805–11.CrossRefPubMed Yeh KW, Yu CH, Chan PC, Horng JT, Huang JL. Burden of systemic lupus erythematosus in Taiwan: a population-based survey. Rheumatol Int. 2013;33:1805–11.CrossRefPubMed
5.
go back to reference Yurkovich M, Vostretsova K, Chen W, Aviña-Zubieta JA. Overall and cause specific mortality in patients with systemic lupus erythematosus: a meta-analysis of observational studies. Arthritis Care Res. 2014;66:608–16.CrossRef Yurkovich M, Vostretsova K, Chen W, Aviña-Zubieta JA. Overall and cause specific mortality in patients with systemic lupus erythematosus: a meta-analysis of observational studies. Arthritis Care Res. 2014;66:608–16.CrossRef
6.
go back to reference Nikpour M, Urowitz MB, Ibanez D, Gladman DD. Frequency and determinants of flare and persistently active disease in systemic lupus erythematosus. Arthritis Rheum. 2009;61:1152–8.CrossRefPubMed Nikpour M, Urowitz MB, Ibanez D, Gladman DD. Frequency and determinants of flare and persistently active disease in systemic lupus erythematosus. Arthritis Rheum. 2009;61:1152–8.CrossRefPubMed
7.
go back to reference Lai JS, Beaumont JL, Jensen SE, Kaiser K, Van Brunt DL, Kao AH, et al. An evaluation of health-related quality of life in patients with systemic lupus erythematosus using PROMIS and neuro-QoL. Clin Rheumatol. 2017;36:555–62.CrossRefPubMed Lai JS, Beaumont JL, Jensen SE, Kaiser K, Van Brunt DL, Kao AH, et al. An evaluation of health-related quality of life in patients with systemic lupus erythematosus using PROMIS and neuro-QoL. Clin Rheumatol. 2017;36:555–62.CrossRefPubMed
8.
go back to reference Yazdany J, Marafino BJ, Dean ML, Bardach NS, Duseja R, Ward MM, et al. Thirty-day hospital readmissions in systemic lupus erythematosus: predictors and hospital- and state-level variation. Arthritis Rheum. 2014;66:2828–36.CrossRef Yazdany J, Marafino BJ, Dean ML, Bardach NS, Duseja R, Ward MM, et al. Thirty-day hospital readmissions in systemic lupus erythematosus: predictors and hospital- and state-level variation. Arthritis Rheum. 2014;66:2828–36.CrossRef
9.
go back to reference Teh CL, Chan GYL, Lee J. Systemic lupus erythematosus in a tertiary, east Malaysian hospital: admission, readmission and death. Int J Rheum Dis. 2008;11:24–9.CrossRef Teh CL, Chan GYL, Lee J. Systemic lupus erythematosus in a tertiary, east Malaysian hospital: admission, readmission and death. Int J Rheum Dis. 2008;11:24–9.CrossRef
10.
go back to reference Khamashta MA, Bruce IN, Gordon C, Isenberg DA, Ateka-Barrutia O, Gayed M, et al. The cost of care of systemic lupus erythematosus (SLE) in the UK annual direct costs for adult SLE patients with active autoantibody-positive disease. Lupus. 2014;23:273–83.CrossRefPubMed Khamashta MA, Bruce IN, Gordon C, Isenberg DA, Ateka-Barrutia O, Gayed M, et al. The cost of care of systemic lupus erythematosus (SLE) in the UK annual direct costs for adult SLE patients with active autoantibody-positive disease. Lupus. 2014;23:273–83.CrossRefPubMed
12.
go back to reference Anandarajah AP, Luc M, Ritchlin CT. Hospitalization of patients with systemic lupus erythematosus is a major cause of direct and indirect healthcare costs. Lupus. 2016;26:756–61.CrossRefPubMed Anandarajah AP, Luc M, Ritchlin CT. Hospitalization of patients with systemic lupus erythematosus is a major cause of direct and indirect healthcare costs. Lupus. 2016;26:756–61.CrossRefPubMed
13.
go back to reference Agborsangaya CB, Lau D, Lahtinen M, Cooke T, Johnson JA. Health-related quality of life and healthcare utilization in multimorbidity: results of a cross-sectional survey. Qual Life Res. 2013;22:791–9.CrossRefPubMed Agborsangaya CB, Lau D, Lahtinen M, Cooke T, Johnson JA. Health-related quality of life and healthcare utilization in multimorbidity: results of a cross-sectional survey. Qual Life Res. 2013;22:791–9.CrossRefPubMed
14.
go back to reference Khanna S, Pal H, Pandey RM, Handa R. The relationship between disease activity and quality of life in systemic lupus erythematosus. Rheumatology (Oxford). 2004;43:1536–40.CrossRef Khanna S, Pal H, Pandey RM, Handa R. The relationship between disease activity and quality of life in systemic lupus erythematosus. Rheumatology (Oxford). 2004;43:1536–40.CrossRef
15.
go back to reference Sahebi A, Mohammadaliha J, Ansariramandi M, Naderi N. Investigation the relationship between self-care and readmission in patients with chronic heart failure. Res Cardiovasc Med. 2015;4:e25472.PubMedPubMedCentral Sahebi A, Mohammadaliha J, Ansariramandi M, Naderi N. Investigation the relationship between self-care and readmission in patients with chronic heart failure. Res Cardiovasc Med. 2015;4:e25472.PubMedPubMedCentral
17.
go back to reference Guo XJ, Li L, Jiang MH. Present situation and influencing factors of self-care ability of patients with systemic lupus erythematosus. Chin J Mod Nurs. 2014;20:3582–5. Guo XJ, Li L, Jiang MH. Present situation and influencing factors of self-care ability of patients with systemic lupus erythematosus. Chin J Mod Nurs. 2014;20:3582–5.
18.
go back to reference Zirkzee EJ, Steup-Beekman GM, Schouffoer AA, Henquet SM, Caljouw MA, Huizinga TW, et al. Health care in systemic lupus erythematosus (SLE) the patient's perspective. Clin Rheumatol. 2014;33:1279–87.CrossRefPubMed Zirkzee EJ, Steup-Beekman GM, Schouffoer AA, Henquet SM, Caljouw MA, Huizinga TW, et al. Health care in systemic lupus erythematosus (SLE) the patient's perspective. Clin Rheumatol. 2014;33:1279–87.CrossRefPubMed
19.
go back to reference Danoffburg S, Friedberg F. Unmet needs of patients with systemic lupus erythematosus. Behav Med. 2009;35:5–13.CrossRef Danoffburg S, Friedberg F. Unmet needs of patients with systemic lupus erythematosus. Behav Med. 2009;35:5–13.CrossRef
20.
go back to reference Sullivan S. Development of a systemic lupus erythematosus knowledge questionnaire: the relationship among disease proximity, educational exposure, and knowledge: University of Wisconsin-Milwaukee; 2016. https://dc.uwm.edu/etd/1312 Sullivan S. Development of a systemic lupus erythematosus knowledge questionnaire: the relationship among disease proximity, educational exposure, and knowledge: University of Wisconsin-Milwaukee; 2016. https://​dc.​uwm.​edu/​etd/​1312
21.
go back to reference Liu YF, Chen WJ, Xu WP, Huang JW, Chen QL. Effect of Omaha system-based extending nursing on diabetic patients’ self-care abilities. J Nurs. 2015;22:34–9. Liu YF, Chen WJ, Xu WP, Huang JW, Chen QL. Effect of Omaha system-based extending nursing on diabetic patients’ self-care abilities. J Nurs. 2015;22:34–9.
22.
go back to reference Berre ML, Maimon G, Sourial N, Guériton M, Vedel I. Impact of transitional care services for chronically ill older patients: a systematic evidence review. J Am Geriatr Soc. 2017;65:1597–1608. Berre ML, Maimon G, Sourial N, Guériton M, Vedel I. Impact of transitional care services for chronically ill older patients: a systematic evidence review. J Am Geriatr Soc. 2017;65:1597–1608.
23.
go back to reference Yu DS, Lee DT, Stewart S, Thompson DR, Choi KC, Yu CM. Effect of nurse-implemented transitional care for Chinese individuals with chronic heart failure in Hong Kong: a randomized controlled trial. J Am Geriatr Soc. 2015;63:1583–93.CrossRefPubMed Yu DS, Lee DT, Stewart S, Thompson DR, Choi KC, Yu CM. Effect of nurse-implemented transitional care for Chinese individuals with chronic heart failure in Hong Kong: a randomized controlled trial. J Am Geriatr Soc. 2015;63:1583–93.CrossRefPubMed
24.
go back to reference Clemente D, Leon L, Foster H, Carmona L, Minden K. Transitional care for rheumatic conditions in Europe: current clinical practice and available resources. Pediatr Rheumatol. 2017;15:49.CrossRef Clemente D, Leon L, Foster H, Carmona L, Minden K. Transitional care for rheumatic conditions in Europe: current clinical practice and available resources. Pediatr Rheumatol. 2017;15:49.CrossRef
25.
go back to reference Rees F, Doherty M, Grainge MJ, Lanyon P, Zhang W. The worldwide incidence and prevalence of systemic lupus erythematosus: a systematic review of epidemiological studies. Rheumatology (Oxford). 2017;56:1945–61.CrossRef Rees F, Doherty M, Grainge MJ, Lanyon P, Zhang W. The worldwide incidence and prevalence of systemic lupus erythematosus: a systematic review of epidemiological studies. Rheumatology (Oxford). 2017;56:1945–61.CrossRef
26.
go back to reference Chow SK, Wong FK. A randomized controlled trial of a nurse-led case management programme for hospital-discharged older adults with co-morbidities. J Adv Nurs. 2014;70:2257–71.CrossRefPubMedPubMedCentral Chow SK, Wong FK. A randomized controlled trial of a nurse-led case management programme for hospital-discharged older adults with co-morbidities. J Adv Nurs. 2014;70:2257–71.CrossRefPubMedPubMedCentral
27.
go back to reference Holland DE, Vanderboom CE, Delgado AM, Weiss ME, Monsen KA. Describing pediatric hospital discharge planning care processes using the Omaha system. Appl Nurs Res. 2016;30:24–8.CrossRefPubMed Holland DE, Vanderboom CE, Delgado AM, Weiss ME, Monsen KA. Describing pediatric hospital discharge planning care processes using the Omaha system. Appl Nurs Res. 2016;30:24–8.CrossRefPubMed
29.
go back to reference Jing XM, Jing YJ, Jing JY, Li Y, Mei XP. Evaluation of application effect of Omaha problem classification system in home visit of systemic lupus erythematosus patients. Chin Nurs Res. 2015;16:1957–60. Jing XM, Jing YJ, Jing JY, Li Y, Mei XP. Evaluation of application effect of Omaha problem classification system in home visit of systemic lupus erythematosus patients. Chin Nurs Res. 2015;16:1957–60.
30.
go back to reference Martin KS, Monsen KA, Bowles KH. The Omaha system and meaningful use: applications for practice, education, and research. Comput Inform Nurs. 2011;29:52–8.CrossRefPubMed Martin KS, Monsen KA, Bowles KH. The Omaha system and meaningful use: applications for practice, education, and research. Comput Inform Nurs. 2011;29:52–8.CrossRefPubMed
31.
go back to reference Gladman DD, Ibanez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002;29:288–91.PubMed Gladman DD, Ibanez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002;29:288–91.PubMed
32.
go back to reference Kearney BY, Fleischer BJ. Development of an instrument to measure exercise of self-care agency. Res Nurs Health. 1979;2:25–34.CrossRefPubMed Kearney BY, Fleischer BJ. Development of an instrument to measure exercise of self-care agency. Res Nurs Health. 1979;2:25–34.CrossRefPubMed
33.
go back to reference Wang HH, Laffrey SC. Preliminary development and testing of instruments to measure self-care agency and social support of women in Taiwan. Kaohsiung J Med Sci. 2000;16:459–67.PubMed Wang HH, Laffrey SC. Preliminary development and testing of instruments to measure self-care agency and social support of women in Taiwan. Kaohsiung J Med Sci. 2000;16:459–67.PubMed
34.
go back to reference Wang YB, Xu LY, Yang LS, Yang LM, Yang HR. Reliability and validity of Chinese version of the exercise of self-care agency scale in schizophrenia patients. J Clin Psychiatry. 2014;24:104–7. Wang YB, Xu LY, Yang LS, Yang LM, Yang HR. Reliability and validity of Chinese version of the exercise of self-care agency scale in schizophrenia patients. J Clin Psychiatry. 2014;24:104–7.
35.
go back to reference Stoll T, Gordon C, Burkhardt S, Richardson K, Malik J, Bacon PA, et al. Consistency and validity of patient administered assessment of quality of life by the MOS SF-36; its association with disease activity and damage in patients with systemic lupus erythematosus. J Rheumatol. 1997;24:1608–14.PubMed Stoll T, Gordon C, Burkhardt S, Richardson K, Malik J, Bacon PA, et al. Consistency and validity of patient administered assessment of quality of life by the MOS SF-36; its association with disease activity and damage in patients with systemic lupus erythematosus. J Rheumatol. 1997;24:1608–14.PubMed
37.
go back to reference Pulvirenti M, Mcmillan J, Lawn S. Empowerment, patient centred care and self-management. Health Expect. 2014;17:303–10.CrossRefPubMed Pulvirenti M, Mcmillan J, Lawn S. Empowerment, patient centred care and self-management. Health Expect. 2014;17:303–10.CrossRefPubMed
38.
go back to reference Verhaegh KJ, MacNeil-Vroomen JL, Eslami S, Geerlings SE, de Rooij SE, Buurman BM. Transitional care interventions prevent hospital readmissions for adults with chronic illnesses. Health Aff (Millwood). 2014;33:1531–9.CrossRefPubMed Verhaegh KJ, MacNeil-Vroomen JL, Eslami S, Geerlings SE, de Rooij SE, Buurman BM. Transitional care interventions prevent hospital readmissions for adults with chronic illnesses. Health Aff (Millwood). 2014;33:1531–9.CrossRefPubMed
39.
go back to reference Greenwald JL, Denham CR, Jack BW. The hospital discharge: a review of a high risk care transition with highlights of a reengineered discharge process. J Patient Saf. 2007;3:97–106.CrossRef Greenwald JL, Denham CR, Jack BW. The hospital discharge: a review of a high risk care transition with highlights of a reengineered discharge process. J Patient Saf. 2007;3:97–106.CrossRef
41.
go back to reference Stamp KD, Machado MA, Allen NA. Transitional care programs improve outcomes for heart failure patients: an integrative review. J Cardiovasc Nurs. 2014;29:140–54.CrossRefPubMed Stamp KD, Machado MA, Allen NA. Transitional care programs improve outcomes for heart failure patients: an integrative review. J Cardiovasc Nurs. 2014;29:140–54.CrossRefPubMed
42.
go back to reference Uijen AA, Bischoff EW, Schellevis FG, Bor HH, van den Bosch WJ, Schers HJ. Continuity in different care modes and its relationship to quality of life: a randomised controlled trial in patients with COPD. Br J Gen Pract. 2012;62:e422–8.CrossRefPubMedPubMedCentral Uijen AA, Bischoff EW, Schellevis FG, Bor HH, van den Bosch WJ, Schers HJ. Continuity in different care modes and its relationship to quality of life: a randomised controlled trial in patients with COPD. Br J Gen Pract. 2012;62:e422–8.CrossRefPubMedPubMedCentral
Metadata
Title
Effects of transitional care on self-care, readmission rates, and quality of life in adult patients with systemic lupus erythematosus: a randomized controlled trial
Authors
Xia Xie
Yuqing Song
Hui Yang
Anliu Nie
Hong Chen
Ji-ping Li
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 1/2018
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/s13075-018-1670-4

Other articles of this Issue 1/2018

Arthritis Research & Therapy 1/2018 Go to the issue