Effectiveness of care transition strategies for colorectal cancer patients: a systematic review and meta-analysis.

ABSTRACT

INTRODUCTION: Implementing effective strategies to transition care for individuals with colorectal cancer is an important tool to qualify care for affected individuals, as well as contribute to the dispensation of continuous and quality care to patients. OBJECTIVE: To evaluate the effectiveness of strategies to transition from hospital care to the community compared to usual care for colorectal cancer patients to reduce hospital stay, readmissions at 30 days, and visit to the emergency department up to 30 days. METHOD: Systematic review and meta-analysis followed the recommendations of PRISMA statement, with protocol registered in PROSPERO (CRD 42,020,162,249). Searches were carried out in May 2020 in the following databases PubMed/MEDLINE, LILACS, EMBASE, and Cochrane Central. Meta-analysis was performed using a random-effects model. The measure of effect used for dichotomous outcomes was relative risk, and for continuous outcomes, the difference of means was used, with their confidence intervals of 95%. Heterogeneity was evaluated using inconsistency statistics. RESULTS: Of 631 identified studies, seven studies were included. The meta-analysis of the studies showed a reduction in readmissions at 30 days of 32% and a significant reduction in hospital stay time of approximately one and a half days, both of which were analyzed in favor of the group of care transition interventions. CONCLUSION: The findings showed effective care transition strategies for the transition of colorectal cancer patients, such as post-discharge active surveillance program, standardized protocol of improved recovery, and telephone follow-up. TRIAL REGISTRATION CRD42020162249.