Elita Santosaputri1, Kate Laver1,2, Timothy To1. 1. Department of Rehabilitation, Aged Care, and Palliative Care, Flinders Medical Centre, Adelaide, South Australia, Australia. 2. College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
Abstract
OBJECTIVE: To determine the efficacy of interventions, delivered by geriatrics-trained staff for nursing home residents, in reducing hospitalisation. METHODS: Multiple databases and clinical trial registers were searched. Studies that provided comparative data and involved residents aged ≥65 years evaluating patient-level interventions delivered by geriatrics-trained staff were included. The systematic review protocol was made available on PROSPERO (registration number CRD42017079928; www.crd.york.ac.uk/PROSPERO). RESULTS: Sixteen studies were included; six were randomised controlled trials. Studies were categorised according to intervention approaches into the following: (i) hospital prevention program; (ii) emergency department-based hospital avoidance program; and (iii) post-hospital supported discharge program. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) quality of evidence was low to moderate. Most studies demonstrated a favourable trend; however, only a few reported statistically significant reductions in hospitalisations. Results from the randomised studies were non-significant. CONCLUSIONS: Despite the heterogeneity of studies, there is limited evidence that interventions delivered by geriatrics-trained staff reduce hospitalisations in nursing home residents. Further work examining decision-making around hospital transfer may help inform future intervention design.
OBJECTIVE: To determine the efficacy of interventions, delivered by geriatrics-trained staff for nursing home residents, in reducing hospitalisation. METHODS: Multiple databases and clinical trial registers were searched. Studies that provided comparative data and involved residents aged ≥65 years evaluating patient-level interventions delivered by geriatrics-trained staff were included. The systematic review protocol was made available on PROSPERO (registration number CRD42017079928; www.crd.york.ac.uk/PROSPERO). RESULTS: Sixteen studies were included; six were randomised controlled trials. Studies were categorised according to intervention approaches into the following: (i) hospital prevention program; (ii) emergency department-based hospital avoidance program; and (iii) post-hospital supported discharge program. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) quality of evidence was low to moderate. Most studies demonstrated a favourable trend; however, only a few reported statistically significant reductions in hospitalisations. Results from the randomised studies were non-significant. CONCLUSIONS: Despite the heterogeneity of studies, there is limited evidence that interventions delivered by geriatrics-trained staff reduce hospitalisations in nursing home residents. Further work examining decision-making around hospital transfer may help inform future intervention design.
Authors: Zhifeng Cen; Junlei Li; Hao Hu; Ka Cheng Lei; Cheng I Loi; Zuanji Liang; Tek Fai Chan; Carolina Oi Lam Ung Journal: Front Public Health Date: 2022-09-29