Anne Göhner1,2, Eva Maria Bitzer3, Elena Dreher4, Erik Farin-Glattacker5, Bernhard Heimbach4, Katharina Kohler4, Andy Maun6, Gloria Metzner5, Sebastian Voigt-Radloff4,7. 1. Zentrum für Geriatrie und Gerontologie Freiburg, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Lehener Straße 88, 79106, Freiburg, Deutschland. anne.goehner@uniklinik-freiburg.de. 2. Public Health & Health Education, Pädagogische Hochschule Freiburg, Freiburg, Deutschland. anne.goehner@uniklinik-freiburg.de. 3. Public Health & Health Education, Pädagogische Hochschule Freiburg, Freiburg, Deutschland. 4. Zentrum für Geriatrie und Gerontologie Freiburg, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Lehener Straße 88, 79106, Freiburg, Deutschland. 5. Sektion Versorgungsforschung und Rehabilitationsforschung, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland. 6. Institut für Allgemeinmedizin, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland. 7. Institut für Evidenz in der Medizin (für Cochrane Deutschland Stiftung), Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland.
Abstract
BACKGROUND: The number of multiple chronically ill older people is increasing and multimorbidity is associated with high utilization of health services. Integrated care management is increasingly used to address this problem; however, there is a substantial lack of reliable data on its effectiveness in this target group. OBJECTIVE: To assess the effectiveness of components of integrated care management in adults of all ages and to estimate the transferability to older, multimorbid people in Germany. METHODS: A systematic search was carried out in the Cochrane Library for Cochrane reviews (CR) on (a) the 13 most frequent health problems in old age, which (b) evaluated components of integrated care management in (c) adults of all ages. Experts assessed the transferability of the included CR to multiple chronically ill older people in Germany. RESULTS: Out of 1412 hits 126 CR were included. Regarding independence and functional health outcomes, 25 CR showed clinically relevant results with at least a moderate level of evidence. The following intervention components were estimated to be transferable and could be adapted to be part of an effective integrated care management for multimorbid chronically ill older people, specified by indications and taking identified barriers into account: (1) physical activation, (2) multidisciplinary interventions (3) interventions that enhance self-management, (4) cognitive therapy modalities, (5) telemedical interventions and (6) disease management programs. CONCLUSION: The effectiveness of the identified components in frail older patients should be assessed in care-related and patient-related randomized controlled studies.
BACKGROUND: The number of multiple chronically ill older people is increasing and multimorbidity is associated with high utilization of health services. Integrated care management is increasingly used to address this problem; however, there is a substantial lack of reliable data on its effectiveness in this target group. OBJECTIVE: To assess the effectiveness of components of integrated care management in adults of all ages and to estimate the transferability to older, multimorbid people in Germany. METHODS: A systematic search was carried out in the Cochrane Library for Cochrane reviews (CR) on (a) the 13 most frequent health problems in old age, which (b) evaluated components of integrated care management in (c) adults of all ages. Experts assessed the transferability of the included CR to multiple chronically ill older people in Germany. RESULTS: Out of 1412 hits 126 CR were included. Regarding independence and functional health outcomes, 25 CR showed clinically relevant results with at least a moderate level of evidence. The following intervention components were estimated to be transferable and could be adapted to be part of an effective integrated care management for multimorbid chronically ill older people, specified by indications and taking identified barriers into account: (1) physical activation, (2) multidisciplinary interventions (3) interventions that enhance self-management, (4) cognitive therapy modalities, (5) telemedical interventions and (6) disease management programs. CONCLUSION: The effectiveness of the identified components in frail older patients should be assessed in care-related and patient-related randomized controlled studies.
Entities:
Keywords:
Aged; Community; Coordinated Care; Health Care; Multimorbid
Authors: L Susan Wieland; Nicole Skoetz; Karen Pilkington; Ramaprabhu Vempati; Christopher R D'Adamo; Brian M Berman Journal: Cochrane Database Syst Rev Date: 2017-01-12
Authors: Jan Mehrholz; Simone Thomas; Cordula Werner; Joachim Kugler; Marcus Pohl; Bernhard Elsner Journal: Cochrane Database Syst Rev Date: 2017-05-10
Authors: Andrew M Briggs; Pim P Valentijn; Jotheeswaran A Thiyagarajan; Islene Araujo de Carvalho Journal: BMJ Open Date: 2018-04-07 Impact factor: 2.692
Authors: Floor J van Deudekom; Iris Postmus; Danielle J van der Ham; Alexander B Pothof; Karen Broekhuizen; Gerard J Blauw; Simon P Mooijaart Journal: PLoS One Date: 2017-03-27 Impact factor: 3.240