Effects of an Updated Preventive Home Visit Program Based on a Systematic Structured Assessment of Care Needs for Ambulatory Frail Older Adults in Japan: A Randomized Controlled Trial

Kono, Ayumi; Izumi, Kiyohiko; Yoshiyuki, Noriko; Kanaya, Yukiko; Rubenstein, Laurence Z.

doi:10.1093/gerona/glw068

Cited by 18 publications

(27 citation statements)

References 21 publications

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“…Four outcome measures did not reach significance in any of the interventions: pain, role, social support and health‐related quality of life. We found an effect in favour of the control group only twice: reported morbidities (Burns, Nichols, Graney, & Cloar, ) and life satisfaction (Kono et al, ).…”

Section: Resultsmentioning

confidence: 58%

The (cost‐)effectiveness of preventive, integrated care for community‐dwelling frail older people: A systematic review

Looman

Huijsman

Fabbricotti

2018

Health Soc Care Community

123

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Integrated care is increasingly promoted as an effective and cost-effective way to organise care for community-dwelling frail older people with complex problems but the question remains whether high expectations are justified. Our study aims to systematically review the empirical evidence for the effectiveness and cost-effectiveness of preventive, integrated care for community-dwelling frail older people and close attention is paid to the elements and levels of integration of the interventions. We searched nine databases for eligible studies until May 2016 with a comparison group and reporting at least one outcome regarding effectiveness or cost-effectiveness. We identified 2,998 unique records and, after exclusions, selected 46 studies on 29 interventions. We assessed the quality of the included studies with the Effective Practice and Organization of Care risk-of-bias tool. The interventions were described following Rainbow Model of Integrated Care framework by Valentijn. Our systematic review reveals that the majority of the reported outcomes in the studies on preventive, integrated care show no effects. In terms of health outcomes, effectiveness is demonstrated most often for seldom-reported outcomes such as well-being. Outcomes regarding informal caregivers and professionals are rarely considered and negligible. Most promising are the care process outcomes that did improve for preventive, integrated care interventions as compared to usual care. Healthcare utilisation was the most reported outcome but we found mixed results. Evidence for cost-effectiveness is limited. High expectations should be tempered given this limited and fragmented evidence for the effectiveness and cost-effectiveness of preventive, integrated care for frail older people. Future research should focus on unravelling the heterogeneity of frailty and on exploring what outcomes among frail older people may realistically be expected.

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Section: Resultsmentioning

confidence: 58%

The (cost‐)effectiveness of preventive, integrated care for community‐dwelling frail older people: A systematic review

Looman

Huijsman

Fabbricotti

2018

Health Soc Care Community

123

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“…Of the 37 articles included in this review, 27 used quantitative 16,27–51 and 10 used qualitative methodologies. 52–61 Almost half ( n = 18) of the studies were conducted in the US 28,29,32,33,36,39–42,44–48,50,59,62 followed by Australia ( n = 5) 27,53–55,58 and Canada ( n = 4).…”

Section: Resultsmentioning

confidence: 99%

“…Some approaches focus on the coordination of care among multiple services, 34,50 while others focused on caring for patients with multiple comorbid conditions. 37 Method of care provision: Many instances of case management led by both interdisciplinary teams (n = 7) 28,31,36,38,42,45,56 and nurses (n = 4) 44,46,50,52 included a home visit component. In these approaches, a nurse, case manager, or interdisciplinary team member visits the patient's home to conduct an assessment and facilitate development of the care plan.…”

Section: Characteristics Of Case Management Modelsmentioning

confidence: 99%

Case Management Models and Continuing Care: A Literature Review across nations, settings, approaches, and assessments

Gallant

Cassidy

et al. 2020

Home Health Care Management & Practice

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Older adults accessing continuing care often have multiple chronic conditions. Research suggests that case management is a promising approach to reduce health care expenditure and improve patient outcomes. To optimize healthcare delivery, an examination of existing case management models and their effectiveness is essential. This literature review was conducted using Joanna Briggs Institute (JBI) methods to explore case management models for older adults accessing continuing care services. Searches were conducted in PubMed and CINAHL from 2010 to 2018. A total of 37 articles were included in this review. Approaches to case management are diverse with respect to composition of care providers, method of care provision, and location of care. Findings from 27 quantitative studies demonstrated that nurse-led and interdisciplinary team case management models that include home visits can effectively reduce hospital admission/readmission while lowering costs. Mixed results were found on the impact of case management on patient satisfaction, ED visits, quality of life, length of stay, self-efficacy, social integration and caregiver burden. Among 10 qualitative studies, 3 facilitators for quality case management were identified that include receiving care at home, building trusting relationships, and improving self-efficacy. Based on these findings, we conclude that nurse-led and interdisciplinary team case management can effectively reduce hospital admission of frail older adults while lowering costs, particularly within home care settings.

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“…This resulted in a total of 52 scientific papers describing 27 integrated care programs and 21 different CGA instruments. For one integrated care program, we present both the original and the updated program (Kono et al, ; Kono, Izumi, Yoshiyuki, Kanaya, & Rubenstein, ). As the programs were rather different, they were included as two separate programs.…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, domains were defined in different ways in CGAs. For example, in some CGAs, cognitive functioning was part of the psychological/mental domain (Kono et al, ; Stijnen, Duimel‐Peeters, et al, ; Suijker et al, , ), while in other CGAs, cognition was a domain separate from the psychological/mental domain (Boult et al, ; Boyd et al, ; Ruikes et al, , ).…”

Section: Resultsmentioning

confidence: 99%

Comprehensive geriatric assessments in integrated care programs for older people living at home: A scoping review

Stoop

Lette

Gils

et al. 2019

Health Soc Care Community

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In many integrated care programs, a comprehensive geriatric assessment (CGA) is conducted to identify older people's problems and care needs. Different ways for conducting a CGA are in place. However, it is still unclear which CGA instruments and procedures for conducting them are used in integrated care programs, and what distinguishes them from each other. Furthermore, it is yet unknown how and to what extent CGAs, as a component of integrated care programs, actually reflect the main principles of integrated care, being comprehensiveness, multidisciplinarity and person‐centredness. Therefore, the objectives of this study were to: (a) describe and compare different CGA instruments and procedures conducted within integrated care programs for older people living at home, and (b) describe how the principles of integrated care were applied in these CGAs. A scoping review of the scientific literature on CGAs in the context of integrated care was conducted for the period 2006–2018. Data were extracted on main characteristics of the identified CGA instruments and procedures, and on how principles of integrated care were applied in these CGAs. Twenty‐seven integrated care programs were included in this study, of which most were implemented in the Netherlands and the United States. Twenty‐one different CGAs were identified, of which the EASYcare instrument, RAI‐HC/RAI‐CHA and GRACE tool were used in multiple programs. The majority of CGAs seemed to reflect comprehensiveness, multidisciplinarity and person‐centredness, although the way and extent to which principles of integrated care were incorporated differed between the CGAs. This study highlights the high variability of CGA instruments and procedures used in integrated care programs. This overview of available CGAs and their characteristics may promote (inter‐)national exchange of CGAs, which could enable researchers and professionals in choosing from the wide range of existing CGAs, thereby preventing them from unnecessarily reinventing the wheel.

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Effects of an Updated Preventive Home Visit Program Based on a Systematic Structured Assessment of Care Needs for Ambulatory Frail Older Adults in Japan: A Randomized Controlled Trial

Abstract: These results suggest that the updated preventive home visit program could be effective for the prevention of ADL and care-needs deterioration, and these effects could continue up to 1 year after program completion.

Cited by 18 publications

References 21 publications

The (cost‐)effectiveness of preventive, integrated care for community‐dwelling frail older people: A systematic review

The (cost‐)effectiveness of preventive, integrated care for community‐dwelling frail older people: A systematic review

Case Management Models and Continuing Care: A Literature Review across nations, settings, approaches, and assessments

Comprehensive geriatric assessments in integrated care programs for older people living at home: A scoping review

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