REVIEW OF NURSE-LED INTERVENTIONS IN REDUCING HOSPITAL READMISSION RATES AMONG ELDERLY PATIENTS WITH CHRONIC ILLNESSES: A SYSTEMATIC REVIEW

Abstract

Background: Hospital readmissions among elderly patients with chronic illnesses remain a major global healthcare concern, leading to increased morbidity, reduced quality of life, and escalating healthcare costs. Nurse-led interventions have emerged as a promising approach to improve care continuity and reduce preventable readmissions. However, existing studies show variability in design, outcomes, and intervention types, necessitating a systematic synthesis of evidence to establish their effectiveness.

Objective: This systematic review aims to evaluate the impact of nurse-led interventions on hospital readmission rates among elderly patients with chronic illnesses, assessing their effectiveness compared to standard or physician-led care.

Methods: Following PRISMA 2020 guidelines, a systematic search was conducted across PubMed, Scopus, Web of Science, and the Cochrane Library for studies published between 2015 and 2025. Eligible studies included randomized controlled trials, quasi-experimental, and observational designs focusing on nurse-led interventions for adults aged ≥65 with chronic conditions. Data extraction and quality appraisal were performed independently by two reviewers using standardized tools, including the Cochrane Risk of Bias 2 and Newcastle-Ottawa Scale. A narrative synthesis and meta-analysis using a random-effects model were performed to summarize outcomes.

Results: Eight studies involving 8,945 participants were included. Nurse-led interventions—such as transitional care, home visits, telehealth follow-up, and education—significantly reduced hospital readmission rates (RR = 0.67; 95% CI 0.49–0.92; p = 0.01). Secondary outcomes demonstrated improved self-management, medication adherence, and quality of life. Heterogeneity was moderate (I² = 58%), and the overall risk of bias was low to moderate.

Conclusion: Nurse-led interventions effectively reduce hospital readmissions and improve overall care outcomes among elderly patients with chronic diseases. These findings highlight the critical role of nurses in transitional and chronic care management. Nonetheless, further large-scale, standardized RCTs are required to confirm long-term effectiveness and cost-efficiency across diverse healthcare systems.