Bloemen-Vrencken et al. 2007
Netherlands
Downs & Black = 15
Prospective Controlled Trial
N=62

Population: 31 experimental subjects (24 male, 7 female); mean age: 37.8±13.8 yrs; Injury: paraplegia (n=18) or tetraplegia (n=13). 31 control subjects (24 male, 7 female); mean age: 36.1±13.6 yrs; Injury: paraplegia (n=18) or tetraplegia (n=13).
Treatment:  Transmural care (nurse as a liaison between subject, primary care and rehabilitation centre) for at least 1 yr after discharge in addition to the usual follow-up care;  Control group: received usual follow-up including periodic outpatient visits to rehabilitation center.
Outcome measures: Prevalence of pressure sores and urinary tract infections during first year after discharge; number and duration of re-admissions to hospital and rehabilitation centers due to pressure sores, bladder and bowel problems in the first year after discharge.

1. No significant difference seen in prevalence of pressure sores and urinary tract infections between groups.
2. No significant differences seen in re-admission rates between groups.
3. Quality of follow-up care experienced not significantly different between groups. 

Prabhaka and Thakker 2003
India
Downs & Black = 8
Post-test
N=546

Population: 546 subjects (164 male, 382 female);
Treatment: A home visit with outreach team consisting of: counsellor, surgeon, physiotherapist, occupational therapist, prosthetist and orthotist engineer, medical social worker and a nurse. Complete assessment of rehabilitation performed including vocational, bladder-bowel, and sexual rehabilitation. Researched problems faced by SCI patients, family and societal relations, available support and opportunities for vocational rehabilitation.
Outcome measures: Evaluation and improvement of rehabilitation to decrease the rate of hospital re-admissions.

1. Home visit program decreased the number of re-admissions, improved status of rehabilitation and raised quality of care for patients.

Beck and Scroggins 2001
USA
Downs & Black = 6
Pre-post
N=19

Population: Persons with tetraplegia (n=3) and long-term health care providers (n=16).
Treatment: Health Maintenance Education Program made up of 3 phases: 1. 1-day interdisciplinary workshop to provide research-based knowledge on care; 2. Collaborative home visit to provide individualized assessment, education and intervention; 3. 12-months of on-going support to the consumer and care provider relationship.
Outcome measures: Program evaluation forms

1. Statistically significant increase in knowledge of: prevention of respiratory complications (p<0.05); prevention & treatment of autonomic dysreflexia (p<0.05); prevention of spasticity (p<0.01); reportable symptoms (p<0.01); effects of aging (p<0.001); availability of community resources (p<0.01).
2. Benefits included: demonstration of skills, on-site evaluation, awareness of resources
3. Suggested modifications: educational content regarding client vulnerability, client advocacy, discussion of role of agencies.

Williams 2005
UK
Downs & Black = 4
Case-series
N=31

Population: 31 subjects seen at experimental nurse-led clinic on 6 different days
Treatment: Nurse-led clinic: holistic nursing assessment, peer-support group,
Outcome measures: Effectiveness of nurse-led services

1. Reported benefits from nurses’ up-to-date knowledge of specific bowel/bladder problem-solving approaches.
2. Patients perceived nurses to be more understanding, better informed and found sessions more informative, practical and helpful.