The population comprised adult medical patients in acute care settings at discharge. Medical patients consisted of emergency department admissions and patients with chronic diseases such as diabetes, cardiac disease, respiratory disease, chronic kidney disease and organ failure/transplant. A total of 16,070 participants were included in the review, with each study's sample size ranging from 25 to 3,386 participants.

There were 60 studies included in the review, 19 of which were randomized control trials (RCTs). Over 58% of the RCTS had a low risk of bias (n=11). A p-value < .05 was statistically significant. The authors report a significant association between communication interventions and fewer readmissions to the hospital, although heterogeneity was low (P=0.34). The communication interventions included medication counseling (n=10), education regarding disease management (n=6), and specific communication techniques (n=4). Specific communication techniques included motivational interviewing, teach-back, encouragement of treatment adherence and the patient’s involvement in treatment decisions. There were significant associations (P=<0.01) across studies (n=20) between communication intervention and adherence to treatment regimen 30 days after discharge. There were no associations between communication intervention and mortality 30 days after discharge nor returning to the emergency department. Finally, 13 studies found an association between communication and knowledge of medication and diagnosis 30 days after discharge.

The review findings make sense. The authors were forthcoming in study limitations and the continued need to validate communication intervention associations.

The findings are vital for nursing as they consider interventions in educating culturally diverse medical patients and families about disease processes and medication management. This communication does not stop after physician, clinician, or pharmaceutical counseling but is a recursive process amongst the interdisciplinary team. Communication interventions such as teach-back, handouts, and counseling referrals are given during the stay and enforced at hospital discharge. Utilizing both effective and skilled communication interventions is imperative and has associations with increased adherence, patient satisfaction, and successful patient outcomes.