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Efficacy of interventions led by staff with geriatrics expertise in reducing hospitalisation in nursing home residents: A systematic review
Author(s) -
Santosaputri Elita,
Laver Kate,
To Timothy
Publication year - 2019
Publication title -
australasian journal on ageing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.63
H-Index - 34
eISSN - 1741-6612
pISSN - 1440-6381
DOI - 10.1111/ajag.12593
Subject(s) - medicine , geriatrics , psychological intervention , grading (engineering) , intervention (counseling) , randomized controlled trial , gerontological nursing , family medicine , nursing homes , nursing , medline , psychiatry , civil engineering , surgery , engineering , political science , law
Objective To determine the efficacy of interventions, delivered by geriatrics‐trained staff for nursing home residents, in reducing hospitalisation. Methods Multiple databases and clinical trial registers were searched. Studies that provided comparative data and involved residents aged ≥65 years evaluating patient‐level interventions delivered by geriatrics‐trained staff were included. The systematic review protocol was made available on PROSPERO (registration number CRD 42017079928; www.crd.york.ac.uk/PROSPERO ). Results Sixteen studies were included; six were randomised controlled trials. Studies were categorised according to intervention approaches into the following: (i) hospital prevention program; (ii) emergency department‐based hospital avoidance program; and (iii) post‐hospital supported discharge program. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) quality of evidence was low to moderate. Most studies demonstrated a favourable trend; however, only a few reported statistically significant reductions in hospitalisations. Results from the randomised studies were non‐significant. Conclusions Despite the heterogeneity of studies, there is limited evidence that interventions delivered by geriatrics‐trained staff reduce hospitalisations in nursing home residents. Further work examining decision‐making around hospital transfer may help inform future intervention design.