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Multidisciplinary interventions for reducing the avoidable displacement from home of frail older people: a systematic review

Sempé, Lucas, Billings, Jenny R., Lloyd-Sherlock, Peter (2019) Multidisciplinary interventions for reducing the avoidable displacement from home of frail older people: a systematic review. BMJ Open, 9 (11). Article Number 30687. E-ISSN 2044-6055. (doi:10.1136/bmjopen-2019-030687) (KAR id:76151)

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Abstract

Objectives: To synthesise existing literature on interventions addressing a new concept of avoidable displacement from home for older people with multimorbidity or frailty. The review focused on home-based interventions by any type of multidisciplinary team aimed at reducing avoidable displacement from home to hospital settings. A second objective was to characterise these interventions to inform policy. Design: A systematic search of the main bibliographic databases was conducted to identify studies relating to interventions addressing avoidable displacement from home for older people. Studies focusing on one specific condition or interventions without multidisciplinary teams were excluded. A narrative synthesis of data was conducted, and themes were identified by using an adapted thematic framework analysis approach. Results: The search strategy was performed using the following electronic databases: the American National Library of Medicine and the National Institutes of Health (PubMed), Scopus, Cochrane Library (Central and CDRS), CINAHL, Social Care Online, Web of Science as well as the database of the Latin American and Caribbean Health Sciences Literature (LILACS). The database search was done in September 2018 and completed in October 2018. Overall 3927 articles were identified and 364 were retained for full text screening. Fifteen studies were included in the narrative review. Four themes were identified and discussed: (1) types of interventions; (2) composition of teams; (3) intervention effectiveness; and (4) types of outcomes. Within intervention types, three categories of care types were identified; transitional care, case-management services and hospital at home. Each individual article was assessed in terms of risk of bias following Cochrane Collaboration guidelines. Conclusions: The review identified some potential interventions and relevant topics to be addressed in order to develop effective and sustainable interventions to reduce the avoidable displacement from home of older people. However the review was not able to identify robust impact evidence, either in terms of quantity or quality from the studies presented. As such, the available evidence is not sufficiently robust to inform policy or interventions for reducing avoidable displacement from home. This finding reflects the complexity of these interventions and a lack of systematic data collection.

Item Type: Article
DOI/Identification number: 10.1136/bmjopen-2019-030687
Uncontrolled keywords: avoidable displacement from home, healthcare, older people, social care, systematic review
Subjects: H Social Sciences
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Jennifer Billings
Date Deposited: 03 Sep 2019 12:55 UTC
Last Modified: 17 Sep 2020 15:56 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/76151 (The current URI for this page, for reference purposes)
Billings, Jenny R.: https://orcid.org/0000-0002-5660-9478
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