Mi Puente (My Bridge) Care Transitions Program for Hispanic/Latino Adults with Multimorbidity: Results of a Randomized Controlled Trial
Background Multimorbidity frequently co-occurs with behavioral health concerns and leads to increased healthcare costs and reduced quality and quantity of life. Unplanned readmissions are a primary driver of high healthcare costs. Objective We tested the effectiveness of a culturally appropriate car...
Gespeichert in:
| Veröffentlicht in: | Journal of general internal medicine : JGIM 2023-07, Vol.38 (9), p.2098-2106 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 2106 |
|---|---|
| container_issue | 9 |
| container_start_page | 2098 |
| container_title | Journal of general internal medicine : JGIM |
| container_volume | 38 |
| creator | Gallo, Linda C. Fortmann, Addie L. Clark, Taylor L. Roesch, Scott C. Bravin, Julia I. Spierling Bagsic, Samantha R. Sandoval, Haley Savin, Kimberly L. Gilmer, Todd Talavera, Gregory A. Philis-Tsimikas, Athena |
| description | Background
Multimorbidity frequently co-occurs with behavioral health concerns and leads to increased healthcare costs and reduced quality and quantity of life. Unplanned readmissions are a primary driver of high healthcare costs.
Objective
We tested the effectiveness of a culturally appropriate care transitions program for Latino adults with multiple cardiometabolic conditions and behavioral health concerns in reducing hospital utilization and improving patient-reported outcomes.
Design
Randomized, controlled, single-blind parallel-groups.
Participants
Hispanic/Latino adults (
N
=536; 75% of those screened and eligible;
M
=62.3 years (SD=13.9); 48% women; 73% born in Mexico) with multiple chronic cardiometabolic conditions and at least one behavioral health concern (e.g., depression symptoms, alcohol misuse) hospitalized at a hospital that serves a large, mostly Hispanic/Latino, low-income population.
Interventions
Usual care (UC) involved best-practice discharge processes (e.g., discharge instructions, assistance with appointments). Mi Puente (“My Bridge”; MP) was a culturally appropriate program of UC plus inpatient and telephone encounters with a behavioral health nurse and community mentor team who addressed participants’ social, medical, and behavioral health needs.
Main Measures
The primary outcome was 30- and 180-day readmissions (inpatient, emergency, and observation visits). Patient-reported outcomes (quality of life, patient activation) and healthcare use were also examined.
Key Results
In intention-to-treat models, the MP group evidenced a
higher
rate of recurrent hospitalization (15.9%) versus UC (9.4%) (OR=1.91 (95% CI 1.09, 3.33)), and a greater number of recurrent hospitalizations (
M
=0.20 (SD=0.49) MP versus 0.12 (SD=0.45) UC;
P
=0.02) at 30 days. Similar trends were observed at 180 days. Both groups showed improved patient-reported outcomes, with no advantage in the Mi Puente group. Results were similar in per protocol analyses.
Conclusions
In this at-risk population, the MP group experienced increased hospital utilization and did not demonstrate an advantage in improved patient-reported outcomes, relative to UC. Possible reasons for these unexpected findings are discussed.
Trial Registration
ClinicalTrials.gov
Identifier: NCT02723019. Registered on 30 March 2016. |
| doi_str_mv | 10.1007/s11606-022-08006-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9876654</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2840417603</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-4382ba646be91e733054dcc7ecf61beda8b098b7eb100d457a6341866bef5adc3</originalsourceid><addsrcrecordid>eNp9kctuEzEYhS0EoqHwAiyQJTZlMdS38YUFUomAIiWiqsLa8tie1NWMHewZUHgBXhvTlHJZsPKR_u8_9vEB4ClGLzFC4rRgzBFvECENkqgqfA8scEvaBjMl7oMFkpI1UlB2BB6Vco0QpoTIh-CIcq6EImoBvq8DvJh9nDw8We_hmxzc1r-AS5M93GQTS5hCigVe5LTNZoR9yvA8lJ2JwZ6uzBRigmduHqYCv4bpCq6rDGPKXXBh2r-Cl77cDFMPDbw00aUxfPMOLlOcchqGKjc5mOExeNCbofgnt-cx-PTu7WZ53qw-vv-wPFs1lgk2NYxK0hnOeOcV9oJS1DJnrfC257jzzsgOKdkJ39UfcqwVhlOGJa983xpn6TF4ffDdzd3ona3Jsxn0LofR5L1OJui_JzFc6W36opUUnLesGpzcGuT0efZl0mMo1g-DiT7NRRPBlVKtVG1Fn_-DXqc5xxpPE8kQw4IjWilyoGxOpWTf3z0GI_2zZ33oWdee9U3PGtelZ3_GuFv5VWwF6AEodRS3Pv---z-2PwDwWLWd</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2840417603</pqid></control><display><type>article</type><title>Mi Puente (My Bridge) Care Transitions Program for Hispanic/Latino Adults with Multimorbidity: Results of a Randomized Controlled Trial</title><source>MEDLINE</source><source>SpringerNature Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Gallo, Linda C. ; Fortmann, Addie L. ; Clark, Taylor L. ; Roesch, Scott C. ; Bravin, Julia I. ; Spierling Bagsic, Samantha R. ; Sandoval, Haley ; Savin, Kimberly L. ; Gilmer, Todd ; Talavera, Gregory A. ; Philis-Tsimikas, Athena</creator><creatorcontrib>Gallo, Linda C. ; Fortmann, Addie L. ; Clark, Taylor L. ; Roesch, Scott C. ; Bravin, Julia I. ; Spierling Bagsic, Samantha R. ; Sandoval, Haley ; Savin, Kimberly L. ; Gilmer, Todd ; Talavera, Gregory A. ; Philis-Tsimikas, Athena</creatorcontrib><description>Background
Multimorbidity frequently co-occurs with behavioral health concerns and leads to increased healthcare costs and reduced quality and quantity of life. Unplanned readmissions are a primary driver of high healthcare costs.
Objective
We tested the effectiveness of a culturally appropriate care transitions program for Latino adults with multiple cardiometabolic conditions and behavioral health concerns in reducing hospital utilization and improving patient-reported outcomes.
Design
Randomized, controlled, single-blind parallel-groups.
Participants
Hispanic/Latino adults (
N
=536; 75% of those screened and eligible;
M
=62.3 years (SD=13.9); 48% women; 73% born in Mexico) with multiple chronic cardiometabolic conditions and at least one behavioral health concern (e.g., depression symptoms, alcohol misuse) hospitalized at a hospital that serves a large, mostly Hispanic/Latino, low-income population.
Interventions
Usual care (UC) involved best-practice discharge processes (e.g., discharge instructions, assistance with appointments). Mi Puente (“My Bridge”; MP) was a culturally appropriate program of UC plus inpatient and telephone encounters with a behavioral health nurse and community mentor team who addressed participants’ social, medical, and behavioral health needs.
Main Measures
The primary outcome was 30- and 180-day readmissions (inpatient, emergency, and observation visits). Patient-reported outcomes (quality of life, patient activation) and healthcare use were also examined.
Key Results
In intention-to-treat models, the MP group evidenced a
higher
rate of recurrent hospitalization (15.9%) versus UC (9.4%) (OR=1.91 (95% CI 1.09, 3.33)), and a greater number of recurrent hospitalizations (
M
=0.20 (SD=0.49) MP versus 0.12 (SD=0.45) UC;
P
=0.02) at 30 days. Similar trends were observed at 180 days. Both groups showed improved patient-reported outcomes, with no advantage in the Mi Puente group. Results were similar in per protocol analyses.
Conclusions
In this at-risk population, the MP group experienced increased hospital utilization and did not demonstrate an advantage in improved patient-reported outcomes, relative to UC. Possible reasons for these unexpected findings are discussed.
Trial Registration
ClinicalTrials.gov
Identifier: NCT02723019. Registered on 30 March 2016.</description><identifier>ISSN: 0884-8734</identifier><identifier>ISSN: 1525-1497</identifier><identifier>EISSN: 1525-1497</identifier><identifier>DOI: 10.1007/s11606-022-08006-1</identifier><identifier>PMID: 36697929</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adults ; Aged ; Ambulatory Care ; Cardiometabolic Risk Factors ; Cardiovascular Diseases ; Clinical outcomes ; Comorbidity ; Culturally Competent Care ; Female ; Health care ; Health care expenditures ; Hispanic Americans ; Hispanic or Latino ; Hospital to Home Transition ; Hospitals ; Humans ; Internal Medicine ; Male ; Medicine ; Medicine & Public Health ; Mental Disorders ; Metabolic Diseases ; Middle Aged ; Multimorbidity ; Needs Assessment ; Original Research ; Patient Readmission ; Patient Transfer - methods ; Patients ; Quality of Life ; Single-Blind Method</subject><ispartof>Journal of general internal medicine : JGIM, 2023-07, Vol.38 (9), p.2098-2106</ispartof><rights>The Author(s), under exclusive licence to Society of General Internal Medicine 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Society of General Internal Medicine.</rights><rights>The Author(s), under exclusive licence to Society of General Internal Medicine 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-4382ba646be91e733054dcc7ecf61beda8b098b7eb100d457a6341866bef5adc3</citedby><cites>FETCH-LOGICAL-c474t-4382ba646be91e733054dcc7ecf61beda8b098b7eb100d457a6341866bef5adc3</cites><orcidid>0000-0002-3678-5888</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9876654/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9876654/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,41488,42557,51319,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36697929$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gallo, Linda C.</creatorcontrib><creatorcontrib>Fortmann, Addie L.</creatorcontrib><creatorcontrib>Clark, Taylor L.</creatorcontrib><creatorcontrib>Roesch, Scott C.</creatorcontrib><creatorcontrib>Bravin, Julia I.</creatorcontrib><creatorcontrib>Spierling Bagsic, Samantha R.</creatorcontrib><creatorcontrib>Sandoval, Haley</creatorcontrib><creatorcontrib>Savin, Kimberly L.</creatorcontrib><creatorcontrib>Gilmer, Todd</creatorcontrib><creatorcontrib>Talavera, Gregory A.</creatorcontrib><creatorcontrib>Philis-Tsimikas, Athena</creatorcontrib><title>Mi Puente (My Bridge) Care Transitions Program for Hispanic/Latino Adults with Multimorbidity: Results of a Randomized Controlled Trial</title><title>Journal of general internal medicine : JGIM</title><addtitle>J GEN INTERN MED</addtitle><addtitle>J Gen Intern Med</addtitle><description>Background
Multimorbidity frequently co-occurs with behavioral health concerns and leads to increased healthcare costs and reduced quality and quantity of life. Unplanned readmissions are a primary driver of high healthcare costs.
Objective
We tested the effectiveness of a culturally appropriate care transitions program for Latino adults with multiple cardiometabolic conditions and behavioral health concerns in reducing hospital utilization and improving patient-reported outcomes.
Design
Randomized, controlled, single-blind parallel-groups.
Participants
Hispanic/Latino adults (
N
=536; 75% of those screened and eligible;
M
=62.3 years (SD=13.9); 48% women; 73% born in Mexico) with multiple chronic cardiometabolic conditions and at least one behavioral health concern (e.g., depression symptoms, alcohol misuse) hospitalized at a hospital that serves a large, mostly Hispanic/Latino, low-income population.
Interventions
Usual care (UC) involved best-practice discharge processes (e.g., discharge instructions, assistance with appointments). Mi Puente (“My Bridge”; MP) was a culturally appropriate program of UC plus inpatient and telephone encounters with a behavioral health nurse and community mentor team who addressed participants’ social, medical, and behavioral health needs.
Main Measures
The primary outcome was 30- and 180-day readmissions (inpatient, emergency, and observation visits). Patient-reported outcomes (quality of life, patient activation) and healthcare use were also examined.
Key Results
In intention-to-treat models, the MP group evidenced a
higher
rate of recurrent hospitalization (15.9%) versus UC (9.4%) (OR=1.91 (95% CI 1.09, 3.33)), and a greater number of recurrent hospitalizations (
M
=0.20 (SD=0.49) MP versus 0.12 (SD=0.45) UC;
P
=0.02) at 30 days. Similar trends were observed at 180 days. Both groups showed improved patient-reported outcomes, with no advantage in the Mi Puente group. Results were similar in per protocol analyses.
Conclusions
In this at-risk population, the MP group experienced increased hospital utilization and did not demonstrate an advantage in improved patient-reported outcomes, relative to UC. Possible reasons for these unexpected findings are discussed.
Trial Registration
ClinicalTrials.gov
Identifier: NCT02723019. Registered on 30 March 2016.</description><subject>Adults</subject><subject>Aged</subject><subject>Ambulatory Care</subject><subject>Cardiometabolic Risk Factors</subject><subject>Cardiovascular Diseases</subject><subject>Clinical outcomes</subject><subject>Comorbidity</subject><subject>Culturally Competent Care</subject><subject>Female</subject><subject>Health care</subject><subject>Health care expenditures</subject><subject>Hispanic Americans</subject><subject>Hispanic or Latino</subject><subject>Hospital to Home Transition</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mental Disorders</subject><subject>Metabolic Diseases</subject><subject>Middle Aged</subject><subject>Multimorbidity</subject><subject>Needs Assessment</subject><subject>Original Research</subject><subject>Patient Readmission</subject><subject>Patient Transfer - methods</subject><subject>Patients</subject><subject>Quality of Life</subject><subject>Single-Blind Method</subject><issn>0884-8734</issn><issn>1525-1497</issn><issn>1525-1497</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kctuEzEYhS0EoqHwAiyQJTZlMdS38YUFUomAIiWiqsLa8tie1NWMHewZUHgBXhvTlHJZsPKR_u8_9vEB4ClGLzFC4rRgzBFvECENkqgqfA8scEvaBjMl7oMFkpI1UlB2BB6Vco0QpoTIh-CIcq6EImoBvq8DvJh9nDw8We_hmxzc1r-AS5M93GQTS5hCigVe5LTNZoR9yvA8lJ2JwZ6uzBRigmduHqYCv4bpCq6rDGPKXXBh2r-Cl77cDFMPDbw00aUxfPMOLlOcchqGKjc5mOExeNCbofgnt-cx-PTu7WZ53qw-vv-wPFs1lgk2NYxK0hnOeOcV9oJS1DJnrfC257jzzsgOKdkJ39UfcqwVhlOGJa983xpn6TF4ffDdzd3ona3Jsxn0LofR5L1OJui_JzFc6W36opUUnLesGpzcGuT0efZl0mMo1g-DiT7NRRPBlVKtVG1Fn_-DXqc5xxpPE8kQw4IjWilyoGxOpWTf3z0GI_2zZ33oWdee9U3PGtelZ3_GuFv5VWwF6AEodRS3Pv---z-2PwDwWLWd</recordid><startdate>20230701</startdate><enddate>20230701</enddate><creator>Gallo, Linda C.</creator><creator>Fortmann, Addie L.</creator><creator>Clark, Taylor L.</creator><creator>Roesch, Scott C.</creator><creator>Bravin, Julia I.</creator><creator>Spierling Bagsic, Samantha R.</creator><creator>Sandoval, Haley</creator><creator>Savin, Kimberly L.</creator><creator>Gilmer, Todd</creator><creator>Talavera, Gregory A.</creator><creator>Philis-Tsimikas, Athena</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3678-5888</orcidid></search><sort><creationdate>20230701</creationdate><title>Mi Puente (My Bridge) Care Transitions Program for Hispanic/Latino Adults with Multimorbidity: Results of a Randomized Controlled Trial</title><author>Gallo, Linda C. ; Fortmann, Addie L. ; Clark, Taylor L. ; Roesch, Scott C. ; Bravin, Julia I. ; Spierling Bagsic, Samantha R. ; Sandoval, Haley ; Savin, Kimberly L. ; Gilmer, Todd ; Talavera, Gregory A. ; Philis-Tsimikas, Athena</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-4382ba646be91e733054dcc7ecf61beda8b098b7eb100d457a6341866bef5adc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adults</topic><topic>Aged</topic><topic>Ambulatory Care</topic><topic>Cardiometabolic Risk Factors</topic><topic>Cardiovascular Diseases</topic><topic>Clinical outcomes</topic><topic>Comorbidity</topic><topic>Culturally Competent Care</topic><topic>Female</topic><topic>Health care</topic><topic>Health care expenditures</topic><topic>Hispanic Americans</topic><topic>Hispanic or Latino</topic><topic>Hospital to Home Transition</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mental Disorders</topic><topic>Metabolic Diseases</topic><topic>Middle Aged</topic><topic>Multimorbidity</topic><topic>Needs Assessment</topic><topic>Original Research</topic><topic>Patient Readmission</topic><topic>Patient Transfer - methods</topic><topic>Patients</topic><topic>Quality of Life</topic><topic>Single-Blind Method</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gallo, Linda C.</creatorcontrib><creatorcontrib>Fortmann, Addie L.</creatorcontrib><creatorcontrib>Clark, Taylor L.</creatorcontrib><creatorcontrib>Roesch, Scott C.</creatorcontrib><creatorcontrib>Bravin, Julia I.</creatorcontrib><creatorcontrib>Spierling Bagsic, Samantha R.</creatorcontrib><creatorcontrib>Sandoval, Haley</creatorcontrib><creatorcontrib>Savin, Kimberly L.</creatorcontrib><creatorcontrib>Gilmer, Todd</creatorcontrib><creatorcontrib>Talavera, Gregory A.</creatorcontrib><creatorcontrib>Philis-Tsimikas, Athena</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of general internal medicine : JGIM</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gallo, Linda C.</au><au>Fortmann, Addie L.</au><au>Clark, Taylor L.</au><au>Roesch, Scott C.</au><au>Bravin, Julia I.</au><au>Spierling Bagsic, Samantha R.</au><au>Sandoval, Haley</au><au>Savin, Kimberly L.</au><au>Gilmer, Todd</au><au>Talavera, Gregory A.</au><au>Philis-Tsimikas, Athena</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mi Puente (My Bridge) Care Transitions Program for Hispanic/Latino Adults with Multimorbidity: Results of a Randomized Controlled Trial</atitle><jtitle>Journal of general internal medicine : JGIM</jtitle><stitle>J GEN INTERN MED</stitle><addtitle>J Gen Intern Med</addtitle><date>2023-07-01</date><risdate>2023</risdate><volume>38</volume><issue>9</issue><spage>2098</spage><epage>2106</epage><pages>2098-2106</pages><issn>0884-8734</issn><issn>1525-1497</issn><eissn>1525-1497</eissn><abstract>Background
Multimorbidity frequently co-occurs with behavioral health concerns and leads to increased healthcare costs and reduced quality and quantity of life. Unplanned readmissions are a primary driver of high healthcare costs.
Objective
We tested the effectiveness of a culturally appropriate care transitions program for Latino adults with multiple cardiometabolic conditions and behavioral health concerns in reducing hospital utilization and improving patient-reported outcomes.
Design
Randomized, controlled, single-blind parallel-groups.
Participants
Hispanic/Latino adults (
N
=536; 75% of those screened and eligible;
M
=62.3 years (SD=13.9); 48% women; 73% born in Mexico) with multiple chronic cardiometabolic conditions and at least one behavioral health concern (e.g., depression symptoms, alcohol misuse) hospitalized at a hospital that serves a large, mostly Hispanic/Latino, low-income population.
Interventions
Usual care (UC) involved best-practice discharge processes (e.g., discharge instructions, assistance with appointments). Mi Puente (“My Bridge”; MP) was a culturally appropriate program of UC plus inpatient and telephone encounters with a behavioral health nurse and community mentor team who addressed participants’ social, medical, and behavioral health needs.
Main Measures
The primary outcome was 30- and 180-day readmissions (inpatient, emergency, and observation visits). Patient-reported outcomes (quality of life, patient activation) and healthcare use were also examined.
Key Results
In intention-to-treat models, the MP group evidenced a
higher
rate of recurrent hospitalization (15.9%) versus UC (9.4%) (OR=1.91 (95% CI 1.09, 3.33)), and a greater number of recurrent hospitalizations (
M
=0.20 (SD=0.49) MP versus 0.12 (SD=0.45) UC;
P
=0.02) at 30 days. Similar trends were observed at 180 days. Both groups showed improved patient-reported outcomes, with no advantage in the Mi Puente group. Results were similar in per protocol analyses.
Conclusions
In this at-risk population, the MP group experienced increased hospital utilization and did not demonstrate an advantage in improved patient-reported outcomes, relative to UC. Possible reasons for these unexpected findings are discussed.
Trial Registration
ClinicalTrials.gov
Identifier: NCT02723019. Registered on 30 March 2016.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>36697929</pmid><doi>10.1007/s11606-022-08006-1</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-3678-5888</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0884-8734 |
| ispartof | Journal of general internal medicine : JGIM, 2023-07, Vol.38 (9), p.2098-2106 |
| issn | 0884-8734 1525-1497 1525-1497 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9876654 |
| source | MEDLINE; SpringerNature Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Adults Aged Ambulatory Care Cardiometabolic Risk Factors Cardiovascular Diseases Clinical outcomes Comorbidity Culturally Competent Care Female Health care Health care expenditures Hispanic Americans Hispanic or Latino Hospital to Home Transition Hospitals Humans Internal Medicine Male Medicine Medicine & Public Health Mental Disorders Metabolic Diseases Middle Aged Multimorbidity Needs Assessment Original Research Patient Readmission Patient Transfer - methods Patients Quality of Life Single-Blind Method |
| title | Mi Puente (My Bridge) Care Transitions Program for Hispanic/Latino Adults with Multimorbidity: Results of a Randomized Controlled Trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-02T21%3A28%3A52IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Mi%20Puente%20(My%20Bridge)%20Care%20Transitions%20Program%20for%20Hispanic/Latino%20Adults%20with%20Multimorbidity:%20Results%20of%20a%20Randomized%20Controlled%20Trial&rft.jtitle=Journal%20of%20general%20internal%20medicine%20:%20JGIM&rft.au=Gallo,%20Linda%20C.&rft.date=2023-07-01&rft.volume=38&rft.issue=9&rft.spage=2098&rft.epage=2106&rft.pages=2098-2106&rft.issn=0884-8734&rft.eissn=1525-1497&rft_id=info:doi/10.1007/s11606-022-08006-1&rft_dat=%3Cproquest_pubme%3E2840417603%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2840417603&rft_id=info:pmid/36697929&rfr_iscdi=true |