Case management for integrated care of frail older people in community settings

Sadler, Euan; Khadjesari, Zarnie; Ziemann, Alexandra; Sobolev, Boris; Whitney, Julie; Wilson, Dan; Bakolis, Ioannis; Sevdalis, Nick; Sandall, Jane

doi:10.1002/14651858.cd013088

Cited by 5 publications

(5 citation statements)

References 26 publications

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“…The modified Fried frailty criteria and health determinant factors we examined may be useful in designing rapid nursing assessments to identify at-risk individuals in integrated health care services and case management of community dwelling older adults to promote improved health equity (National Academies of Sciences, Engineering, and Medicine, 2021; Puts et al, 2017; Sadler et al, 2018). We did not study the validity and reliability of our screening test in clinical care coordination models.…”

Section: Discussionmentioning

confidence: 99%

Frailty and Determinants of Health Among Older Adults in the United States 2011–2016

2021

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Objective To characterize frailty phenotype in a representative cohort of older Americans and examine determinants of health factors. Methods Retrospective analysis of data from 5,553 adults ≥60 years old in the 2011–2016 cross-sectional National Health and Nutrition Examination Survey (NHANES). World Health Organization “ Determinants of Health” conceptual model was used to prioritize variables for multinomial logistic regression for the outcome of modified Fried frailty phenotype. Results 482 participants (9%) were frail and 2432 (44%) prefrail. Four factors were highly associated with frailty: difficulty with ≥1 activity of daily living (77%; OR 24.81 p < 0.01), ≥2 hospitalizations in the previous year (17%, OR 3.94 p < 0.01), having >2 comorbidities (27%; OR 3.33 p < 0.01), and polypharmacy (66%; OR 2.38 p < 0.01). Discussion A modified Fried frailty assessment incorporating five self-reported criteria may be useful as a rapid nursing screen in low-resource settings. These assessments can streamline nursing care coordination and case management activities, thereby facilitating targeted frailty interventions to support healthy aging in vulnerable populations.

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Section: Discussionmentioning

confidence: 99%

Frailty and Determinants of Health Among Older Adults in the United States 2011–2016

2021

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“…As populations age, disease burden grows and the health system continues to shift care from the hospital to the community, increasing demand for services in the primary health care setting seems inevitable. Older people with frailty, who are high users of services in the community setting (Sadler et al, 2018), often require home nursing when no longer able to access facility-based services (Murray-Parahi, Edgar, Descallar, Comino, & Johnson, 2017).…”

Section: Introductionmentioning

confidence: 99%

Primary health care content in Australian undergraduate nursing curricula

et al. 2020

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a b s t r a c tThe importance of primary health care PHC is receiving increasing attention. The demand for skilled workers is due to an increased emphasis on community-based care but until recent times pre-registration preparation for nurses, including clinical placements, have focussed on acute care specialties. Aim: To systematically review, measure and describe the PHC content in the undergraduate nursing curriculum in Australian schools of nursing over time. Methods: A cross-sectional study of all Australian universities offering undergraduate (pre-registration) baccalaureate degrees was undertaken in February 2017. Curriculum artifacts were retrieved from university websites. A terminology matrix guided retrieval of PHC content. Findings: All 29 universities offering pre-registration undergraduate nursing degrees in Australia were included in this study. While most universities cite PHC principals as core values underpinning their undergraduate curriculum, only 12 (<2%) of the 694 subject titles had obvious or manifest "primary health care" content and these were mainly offered in 1st and 3rd year. Subject outlines tended to demonstrate more explicit content than subject titles. Discussion: This study confirms ambiguity in PHC interpretation and nomenclature, and opportunities for undergraduate preparation for nursing roles in the home setting is limited. Prospective undergraduate nurses seeking careers in PHC might be deterred by a lack of manifest PHC content in the public domain, which may or may not accurately represent the actual content provided. Conclusion: The predominance of acute episodic care in both curricula and clinical experiences potentially diminishes the importance of PHC. This study offers some direction for education providers and policymakers wishing to attract and prepare next generation nurses for roles in PHC.

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“…Our typology enabled us to progress our NMA of these interventions, which usually estimated low heterogeneity within the intervention groups where this was measurable and could be used by others performing similar syntheses [ 18 ]. For example, our findings could be a starting point for a recent Cochrane review call for a taxonomy of integrated care components [ 9 ]. Our approach to identifying intervention types could be adopted by others seeking to conceptualise or synthesise other complex interventions.…”

Section: Discussionmentioning

confidence: 99%

“…These reviews have not illuminated which components or configurations are most effective—crucial information for policymakers, commissioners and providers. A barrier to this understanding is the lack of an agreed typology for grouping these interventions [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Development of the Community-based complex Interventions to sustain Independence in Older People (CII-OP) typology: a qualitative synthesis of interventions in randomised controlled trials

Crocker,

Jordão,

Lam

et al. 2024

Age and Ageing

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Introduction Community-based services to sustain independence for older people have varying configurations. A typology of these interventions would improve service provision and research by providing conceptual clarity and enabling the identification of effective configurations. We aimed to produce such a typology. Method We developed our typology by qualitatively synthesising community-based complex interventions to sustain independence in older people, evaluated in randomised controlled trials (RCTs), in four stages: (i) systematically identifying relevant RCTs; (ii) extracting descriptions of interventions (including control) using the Template for Intervention Description and Replication; (iii) generating categories of key intervention features and (iv) grouping the interventions based on these categories. PROSPERO registration: CRD42019162195. Results Our search identified 129 RCTs involving 266 intervention arms. The Community-based complex Interventions to sustain Independence in Older People (CII-OP) typology comprises 14 action components and 5 tailoring components. Action components include procedures for treating patients or otherwise intended to directly improve their outcomes; regular examples include formal homecare; physical exercise; health education; activities of daily living training; providing aids and adaptations and nutritional support. Tailoring components involve a process that may result in care planning, with multiple action components being planned, recommended or prescribed. Multifactorial action from care planning was the most common tailoring component. It involves individualised, multidomain assessment and management, as in comprehensive geriatric assessment. Sixty-three different intervention types (combinations) were identified. Conclusions Our typology provides an empirical basis for service planning and evidence synthesis. We recommend better reporting about organisational aspects of interventions and usual care.

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Case management for integrated care of frail older people in community settings

Abstract: Case management for integrated care of frail older people in community settings.

Cited by 5 publications

References 26 publications

Frailty and Determinants of Health Among Older Adults in the United States 2011–2016

Frailty and Determinants of Health Among Older Adults in the United States 2011–2016

Primary health care content in Australian undergraduate nursing curricula

Development of the Community-based complex Interventions to sustain Independence in Older People (CII-OP) typology: a qualitative synthesis of interventions in randomised controlled trials

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