Factors contributing to readmission among heart failure patients receiving care from hospital in the home: an integrative review

<p dir="ltr">Background: Heart failure (HF) remains a leading cause of hospitalisation globally. Affecting 64.34 million individuals worldwide, HF is considered a global burden in terms of mortality and morbidity. Hospital in the Home (HITH) aims to avoid preventable readmissions through additional support and tailored care among patients with chronic long-term conditions. However, the ongoing high readmission rate remains concerning. This dissertation aims to identify contributing factors leading to readmission among HF patients receiving HITH care by exploring patient and caregiver experiences.</p><p dir="ltr">Methods: This integrative review employed an inductive approach following the methodology established by Whittemore and Knafl. The search strategy encompassed four databases, including PubMed, CINAHL, Medline, and APA PsycINFO, and included a search of the included publications' reference lists. The Joanna Briggs Institute Quality Assessment and Review Instrument was used to assess the quality of the included studies. Data extraction was conducted, and findings were presented on a table to facilitate thematic analysis and synthesis.</p><p dir="ltr">Results: Three studies met the inclusion criteria; all were of qualitative study design. Experience leading to readmission among HF patients receiving HITH care was identified and presented under three themes: system roadblocks involved disruptions in care continuity, inconsistencies and lack of integration of care, and challenges with technology; self-management gaps include limitations in knowledge of complex disease, lack of confidence in self-management, need for tailored education, reliance on professional intervention, disruptions in daily life, and financial constraints; social aspects of care relates to social isolation, quality of patient and support network relationship, and caregiver burden and stress</p><p dir="ltr">Conclusion: The complexity of HF disease affecting patient and caregiver well-being highlights the need for HITH services to be well-resourced in providing home care support for patients and caregivers to enhance HF management at home. Additionally, remote technological devices are a primary factor to consider for positive health outcomes among HF patients receiving HITH care.</p>