Effectiveness of Discharge Planning Interventions for Stroke and Heart Conditions: A Systematic Review of Interventional Studies

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Abstract
Objective: To evaluate the effectiveness of discharge planning interventions in improving health outcomes among individuals with stroke and heart conditions, synthesizing evidence from randomized controlled trials and quasi-experimental studies. Methods: Following PRISMA guidelines, seven electronic databases (PubMed/MEDLINE, Scopus, ScienceDirect, CINAHL Plus with Full Text, Web of Science, Ovid, and ClinicalKey Nursing) were searched for studies published between 2019 and 2024. Eligible studies included adults with stroke or heart conditions who received discharge planning interventions, with outcomes compared to usual care or alternative interventions. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool for randomized controlled trials and ROBINS-I for quasi-experimental studies. Data were extracted with a standardized chart and synthesized using a convergent integrated approach in accordance with the Joanna Briggs Institute methodology. Results: Sixteen studies (11 randomized controlled trials and 5 quasi-experimental studies) met the inclusion criteria, representing diverse populations across 11 countries. Interventions included structured discharge programs, early supported discharge, interdisciplinary planning, family-based care, nurse-led eHealth rehabilitation, and technology-enhanced approaches such as SMS, telephone, and interactive voice response systems. Six major outcome themes emerged: (1) healthcare utilization and cost outcomes, (2) patient activation and health behavior change, (3) psychological well-being, (4) functional recovery, (5) health-related quality of life, and (6) caregiver outcomes and support. Although mortality and long-term outcomes showed mixed results, most interventions demonstrated positive short-term effects across clinical, behavioral, and psychosocial domains. Conclusion: Discharge planning interventions improve transitional care and support recovery in stroke and heart disease populations, with particular benefits when multidisciplinary, nurse-led, or digitally supported. This review highlights the value of structured and innovative discharge planning models for clinical practice. Incorporating patient- and caregiver-centered strategies can reduce readmissions, strengthen adherence, and improve long-term health outcomes.

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