Table 5

Summary of intervention effectiveness

Intervention/feature*Notes/caveats
Complex interventions with multiple components

  • Greatest effects when treating patients with single rather than multiple conditions

  • No reviews stated specific components that were more (or less) likely to be effective than others

Postdischarge hospital outreach coordinated by a multidisciplinary team

  • Greatest effects when treating patients with single rather than multiple conditions

  • In contrast, community inreach interventions not effective, even when featuring MDT

  • Not effective for patients who had stroke

MDT with:

  1. Disease-specific specialists as core members

  2. Specialist nurse-led clinics

  3. Pharmacists as collaborative partners

  • Greatest effects when treating patients for single conditions

  • No reviews compared the ‘added value’ that a given professional or clinician may bring to a MDT, so optimal composition remains unknown

Transition from hospital to home is most effective when interventions are initiated during the inpatient phase and continue postdischarge
Home-based community follow-up

  • Effective for reducing length of stay in patients who had stroke

  • Community follow-up least likely to be effective when delivered through a case management model

Self-management education combined with multidisciplinary approaches or discharge planning

  • Greatest effects when treating patients for single conditions

  • Simple self-management interventions were largely ineffective

  • *MDT, multidisciplinary team.