The clinical effectiveness and cost-effectiveness of home-based, nurse-led health promotion for older people: a systematic review.

Abstract

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Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT

“…15 However, it is currently unclear which intervention components are most beneficial for older people with frailty. 16,17 Home-based interventions appear to be promising, with evidence suggesting that they can have beneficial effects on mortality, functioning and emergency department admissions, with neutral effects on costs. [16][17][18][19] Previous evidence supported interventions based on multidimensional geriatric assessment including follow-up visits.…”

“…16,17 Home-based interventions appear to be promising, with evidence suggesting that they can have beneficial effects on mortality, functioning and emergency department admissions, with neutral effects on costs. [16][17][18][19] Previous evidence supported interventions based on multidimensional geriatric assessment including follow-up visits. 15 However, this type of intervention, typically with involvement from a multidisciplinary team of health and social care professionals, is expensive and difficult to deliver at scale, particularly if targeted at the larger group of up to 41% of older people with mild or pre-frailty living at home.…”

Editorial

“…Of these, 19 articles were identifi ed as eligible for inclusion. There were eleven systematic reviews (Gilbody, Bower & Whitty, 2006;Chiu & Newcomer, 2007;Smith & Newton, 2007;Brink-Huis, van Achterberg & Schoonhoven, 2008;Maciejewski, Chen & Au, 2009;Steuten et al, 2009;Pimouguet et al, 2010;van Steenbergen-Weijenburg et al, 2010;Althaus et el., 2011;de Bruin et el., 2011;Smith et al, 2012b), six systematic reviews and meta-analyses (Neumeyer-Gromen et el., 2004;Phillips et al, 2004;Langhorne et al, 2005;Shepperd et al, 2008;Steffen et al, 2009;Tappenden et al, 2012) and two studies not explicitly labelled as systematic reviews but which were included as they met our basic criteria (Oeseburg et al, 2009;Simoens et al, 2011). Two studies (Shepperd et al, 2009;Smith et al, 2012a) identifi ed by our search were based on Cochrane reviews and we therefore retrieved and included the relevant full review for further assessment (Shepperd et al, 2008;Smith et al, 2012b).…”

“…The most common concepts or terms used included case management (Smith & Newton, 2007;Oeseburg et al, 2009;Pimouguet et al, 2010), care coordination (Langhorne et al, 2005;Chiu & Newcomer, 2007), collaborative care (Gilbody, Bower & Whitty, 2006;BrinkHuis, van Achterberg & Schoonhoven, 2008;van Steenbergen-Weijenburg et al, 2010) or a combination of these (Phillips et al, 2004: Shepperd et al, 2008Steffen et al, 2009;Althaus et al, 2011;Smith et al, 2012b;Tappenden et al, 2012), alongside notions such as interdisciplinary care (Brink-Huis, van Achterberg & Schoonhoven, 2008) or seamless care (Simoens et al, 2011). Four reviews focused on disease management interventions, building on multicomponent approaches such as the Chronic Care Model (NeumeyerGromen et al, 2004;Maciejewski, Chen & Au, 2009;Steuten et al, 2009;de Bruin et al, 2011).…”

“…• older people in the community who were considered frail (Oeseburg et al, 2009) or with (long-term) medical or social care needs (Tappenden et al, 2012), with specifi c chronic conditions such as heart failure (Phillips et al, 2004) or who were about to be discharged from hospital (Chiu & Newcomer, 2007);…”