Effect of a nurse-led hospital to home digital health transition program on health outcomes and caregiver burden after CABG: a parallel randomized controlled trial

Patients undergoing coronary artery bypass grafting (CABG) often experience significant challenges during the transition from hospital to home, highlighting the need for structured support to enhance recovery and continuity of care. This study aimed to investigate the effectiveness of a nurse-led hospital-to-home transition care program delivered using digital health via a messaging app in patients and their caregivers following CABG surgery. A parallel randomized controlled trial was conducted on 73 patients undergoing CABG and their family caregivers as dyads in a metropolitan hospital in an urban area of Iran. The participants were recruited between April 2022 and February 2024 after admission to the hospital and before CABG surgery. Eligible dyads were randomly assigned to two groups: the nurse-led intervention group ( n = 37) that received an 8-week structured support program through a messaging app; the control group ( n = 36) that received standard discharge home care. Data were collected at baseline, immediately after the intervention, and two months post-intervention using the Cardiac Self-Efficacy Scale, the MacNew Heart Disease Health-Related Quality of Life Questionnaire, and the Caregiver Burden Scale. Descriptive statistics, chi-square tests, independent t-tests, and repeated-measures ANOVA were used for data analysis. The mean age of patients was 64.64 years in the intervention group and 65.58 years in the control group; 51.4% and 58.3% were male, and 81.1% and 91.7% were married, respectively. The nurse-led digital health home care solution showed significant improvements in self-efficacy ( p < 0.001), health-related quality of life across all domains ( p < 0.001), and caregivers’ burden ( p < 0.001) in the intervention group compared to the control group over time. This single-center randomized controlled trial showed short-term improvements in self-efficacy and health-related quality of life and reduced caregiver burden following CABG. Larger multi-center trials with longer follow-up are required to confirm these findings and assess the intervention in terms of sustainability and generalizability. IRCT20180113038347N2 (Registration date: 11/01/2022).