Is transitional care intervention effective in improving health outcomes for post-percutaneous coronary intervention patients? A systematic review and meta-analysis of randomized controlled trials

Abstract Aims This study aimed to systematically synthesize the currently available body of literature on the impact of transitional care intervention on health outcomes in patients after percutaneous coronary intervention (PCI), focusing on clinical outcomes such as readmission rates, major adverse cardiovascular events (MACE), left ventricular ejection fraction (LVEF), and patient-reported outcomes such as 6 min walk test (6-MWT), quality of life (QoL), and symptoms of anxiety and depression. Furthermore, the study examined the relationship between intervention dosage (including duration, components, and intensity) and improvement in patient health outcomes. Methods and results A comprehensive search was conducted across multiple databases from their inception to November 2024, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This search included randomized controlled trials (RCTs) aimed at assessing the effects of transitional care on postoperative outcomes in patients undergoing PCI. Softer R was used to perform meta-analysis. Twenty-seven studies involving 3345 participants were included. The meta-analysis results showed that transitional care interventions significantly reduced the readmission risk (RR = 0.56, 95% CI: [0.32, 0.98], I2 = 51.7%) and MACE (RR = 0.32, 95% CI: [0.19, 0.53], I2 = 0%). The QoL was significantly improved (SMD = 0.66, 95% CI: [0.31, 1.00], I2 = 89.5%). Furthermore, these interventions had a positive effect on LVEF (SMD = 0.62, 95% CI: [0.24, 1.00], I2 = 65.5%) and 6-MWT (SMD = 0.67, 95% CI: [0.26, 1.08], I2 = 83.0%). Also, they contributed to the reduction of anxiety (SMD = −0.59, 95% CI: [−0.97, −0.22], I2 = 85.6%) and depression (SMD = −0.82, 95% CI: [−1.53, −0.12], I2 = 95.4%) symptoms in patients. Conclusion Transitional care has been shown to have a positive impact on both clinical (e.g. readmissions, MACE, LVEF) and patient-reported (e.g. 6-MWT, QoL, anxiety, depression) outcomes post-PCI. It would be beneficial for future research to prioritize personalized plans based on patient and contextual factors to optimize effects. Registration PROSPERO: CRD42024606447