• Sylvie Cossette, Nancy Frasure-Smith, Alain Vadeboncoeur, Jane McCusker, and Marie-Claude Guertin.
• Faculty of Nursing, University of Montreal, Montreal Heart Institute Research Center, Canada. Electronic address: Sylvie.cossette.inf@umontreal.ca.
• Int J Nurs Stud. 2015 Mar 1; 52 (3): 666-76.

BackgroundAs yet there is no firm evidence about the types of intervention that can reduce emergency room revisits. However, the literature on emergency room revisits suggests patient difficulties with managing their health problems and treatments after discharge may play a role.ObjectivesWe carried out a randomized trial of an emergency department-based nursing intervention, but results showed no reduction in revisits (primary outcome). This paper describes the secondary outcomes of the trial: patient perceptions of continuity of care, illness perceptions, self-care capacities, psychological symptoms and medication adherence 30 days after emergency room discharge.DesignRandomized, controlled trial.SettingsThe trial was conducted in the emergency department of a tertiary cardiac hospital in Montreal, Canada between November 2007 and March 2010.ParticipantsThe study involved 203 patients, including 108 in the experimental group and 95 in the control group.MethodsThe intervention included one nurse patient encounter before discharge and two phone calls in the 10 days after discharge. Participants provided data 30 days post-discharge on secondary outcomes potentially related to emergency department revisits.ResultsAlthough, as previously reported, the intervention had no impact on the primary outcome of emergency department revisits, the present study demonstrated a significant positive effect on patients' perceived continuity of care (p=.033), self-care capacities (p=.037), anxiety (p=.007) and depressive symptoms (p=.043), and the illness perceptions treatment control subscale (p=.037). No differences were found for other illness perception subscales or medication adherence (all p's>.05).ConclusionAlthough the intervention did not influence emergency department revisits it did improve secondary outcomes, suggesting pathways for future research.Copyright © 2015 Elsevier Ltd. All rights reserved.

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