The Library
Acute care models for older people living with frailty : a systematic review and taxonomy
Tools
Knight, Thomas, Kamwa, Vicky, Atkin, Catherine, Green, Catherine, Ragunathan, Janahan, Lasserson, Daniel and Sapey, Elizabeth (2023) Acute care models for older people living with frailty : a systematic review and taxonomy. BMC Geriatrics, 23 . 809. doi:10.1186/s12877-023-04373-4 ISSN 1471-2318.
|
PDF
s12877-023-04373-4.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (2294Kb) | Preview |
|
PDF
ms-161123-wrap--sr_submission_revision_1.pdf - Accepted Version Embargoed item. Restricted access to Repository staff only - Requires a PDF viewer. Download (754Kb) |
Official URL: https://doi.org/10.1186/s12877-023-04373-4
Abstract
Background:
The need to improve the acute care pathway to meet the care needs of older people living with frailty is a strategic priority for many healthcare systems. The optimal care model for this patient group is unclear.
Methods:
A systematic review was conducted to derive a taxonomy of acute care models for older people with acute medical illness and describe the outcomes used to assess their effectiveness. Care models providing time-limited episodes of care (up to 14 days) within 48 hours of presentation to patients over the age of 65 with acute medical illness were included. Care models based in hospital and community settings were eligible.
Searches were undertaken in Medline, Embase, CINAHL and Cochrane databases. Interventions were described and classified in detail using a modified version of the TIDIeR checklist for complex interventions. Outcomes were described and classified using the Core Outcome Measures in Effectiveness Trials (COMET) taxonomy. Risk of bias was assessed using RoB2 and ROBINS-I.
Results:
The inclusion criteria were met by 103 articles. Four classes of acute care model were identified, acute-bed based care, hospital at home, emergency department in-reach and care home models. The field is dominated by small single centre randomised and non-randomised studies. Most studies were judged to be at risk of bias. A range of outcome measures were reported with little consistency between studies. Evidence of effectiveness was limited.
Conclusion:
Acute care models for older people living with frailty are heterogeneous. The clinical effectiveness of these models cannot be conclusively established from the available evidence.
PROSPERO registration (CRD42021279131).
Item Type: | Journal Article | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Alternative Title: | |||||||||||||
Subjects: | H Social Sciences > HV Social pathology. Social and public welfare R Medicine > RA Public aspects of medicine R Medicine > RB Pathology |
||||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
||||||||||||
Library of Congress Subject Headings (LCSH): | Frail older people -- Care, Frail older people -- Home care, Frail older people -- Hospital care | ||||||||||||
Journal or Publication Title: | BMC Geriatrics | ||||||||||||
Publisher: | BioMed Central Ltd. | ||||||||||||
ISSN: | 1471-2318 | ||||||||||||
Official Date: | 5 December 2023 | ||||||||||||
Dates: |
|
||||||||||||
Volume: | 23 | ||||||||||||
Article Number: | 809 | ||||||||||||
DOI: | 10.1186/s12877-023-04373-4 | ||||||||||||
Status: | Peer Reviewed | ||||||||||||
Publication Status: | Published | ||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||||||
Date of first compliant deposit: | 17 November 2023 | ||||||||||||
Date of first compliant Open Access: | 15 January 2024 | ||||||||||||
RIOXX Funder/Project Grant: |
|
||||||||||||
Related URLs: |
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |
Downloads
Downloads per month over past year