BACKGROUND: Home visiting programs have been developed aimed at improving the health and independent functioning of older people. Also, they intend to reduce hospital and nursing home admission and associated cost. A substantial number of studies have examined the effects of preventive home visiting programs on older people living in the community; the findings have been inconsistent. The objective of this review was to assess the effectiveness of intensive home visiting programs targeting older people with poor health or otherwise with functional impairments. METHODS: A search for literature was based on included trials from four reviews on the effectiveness of home visits published after 2000 and on a database search of Cinahl, the Cochrane Central Register of Controlled Trials, Embase, Medline and PsycINFO from 2001 onwards. We also manually searched reference lists from potentially relevant papers. Randomized controlled trials were included assessing the effectiveness of intervention programs consisting of at least four home visits per year, an intervention duration of 12 months or more, and targeting older people (aged 65 years and over) with poor health. Two reviewers independently abstracted data from full papers on program characteristics and outcome measures; they also evaluated the methodological quality. RESULTS: The search identified 844 abstracts; eight papers met the inclusion criteria. Seven trials were of sufficient methodological quality; none of the trials showed a significant favorable effect for the main analysis comparing the intervention group with the control group on mortality, health status, service use or cost. The inclusion of less-intensive intervention programs for frail older persons would not have exerted a great influence on the findings of our review. CONCLUSION: We conclude that home visiting programs appear not to be beneficial for older people with poor health within the health care setting of Western countries.
BACKGROUND: Home visiting programs have been developed aimed at improving the health and independent functioning of older people. Also, they intend to reduce hospital and nursing home admission and associated cost. A substantial number of studies have examined the effects of preventive home visiting programs on older people living in the community; the findings have been inconsistent. The objective of this review was to assess the effectiveness of intensive home visiting programs targeting older people with poor health or otherwise with functional impairments. METHODS: A search for literature was based on included trials from four reviews on the effectiveness of home visits published after 2000 and on a database search of Cinahl, the Cochrane Central Register of Controlled Trials, Embase, Medline and PsycINFO from 2001 onwards. We also manually searched reference lists from potentially relevant papers. Randomized controlled trials were included assessing the effectiveness of intervention programs consisting of at least four home visits per year, an intervention duration of 12 months or more, and targeting older people (aged 65 years and over) with poor health. Two reviewers independently abstracted data from full papers on program characteristics and outcome measures; they also evaluated the methodological quality. RESULTS: The search identified 844 abstracts; eight papers met the inclusion criteria. Seven trials were of sufficient methodological quality; none of the trials showed a significant favorable effect for the main analysis comparing the intervention group with the control group on mortality, health status, service use or cost. The inclusion of less-intensive intervention programs for frail older persons would not have exerted a great influence on the findings of our review. CONCLUSION: We conclude that home visiting programs appear not to be beneficial for older people with poor health within the health care setting of Western countries.
Authors: Maureen Markle-Reid; Gina Browne; Robin Weir; Amiram Gafni; Jacqueline Roberts; Sandra R Henderson Journal: Med Care Res Rev Date: 2006-10 Impact factor: 3.929
Authors: E H Wagner; A Z LaCroix; L Grothaus; S G Leveille; J A Hecht; K Artz; K Odle; D M Buchner Journal: Am J Public Health Date: 1994-11 Impact factor: 9.308
Authors: L P Fried; C M Tangen; J Walston; A B Newman; C Hirsch; J Gottdiener; T Seeman; R Tracy; W J Kop; G Burke; M A McBurnie Journal: J Gerontol A Biol Sci Med Sci Date: 2001-03 Impact factor: 6.053
Authors: M E Tinetti; D I Baker; G McAvay; E B Claus; P Garrett; M Gottschalk; M L Koch; K Trainor; R I Horwitz Journal: N Engl J Med Date: 1994-09-29 Impact factor: 91.245
Authors: Christine S Ritchie; Bruce Leff; Sarah K Garrigues; Carla Perissinotto; Orla C Sheehan; Krista L Harrison Journal: J Am Med Dir Assoc Date: 2018-07-25 Impact factor: 4.669
Authors: Neeltje van den Berg; Claudia Meinke; Melanie Matzke; Romy Heymann; Steffen Flessa; Wolfgang Hoffmann Journal: BMC Health Serv Res Date: 2010-06-08 Impact factor: 2.655
Authors: Janneke A L van Kempen; Sarah H M Robben; Sytse U Zuidema; Marcel G M Olde Rikkert; René J F Melis; Henk J Schers Journal: Br J Gen Pract Date: 2012-08 Impact factor: 5.386
Authors: Mandy M N Stijnen; Inge G P Duimel-Peeters; Maria W J Jansen; Hubertus J M Vrijhoef Journal: BMC Geriatr Date: 2013-01-18 Impact factor: 3.921