Dataset Information

[Integrated care management for older people with chronic diseases in domesticity: evidence from Cochrane reviews].

ABSTRACT:

Background

The number of multiple chronically ill older people is increasing and multimorbidity is associated with high utilization of health services. Integrated care management is increasingly used to address this problem; however, there is a substantial lack of reliable data on its effectiveness in this target group.

Objective

To assess the effectiveness of components of integrated care management in adults of all ages and to estimate the transferability to older, multimorbid people in Germany.

Methods

A systematic search was carried out in the Cochrane Library for Cochrane reviews (CR) on (a) the 13 most frequent health problems in old age, which (b) evaluated components of integrated care management in (c) adults of all ages. Experts assessed the transferability of the included CR to multiple chronically ill older people in Germany.

Results

Out of 1412 hits 126 CR were included. Regarding independence and functional health outcomes, 25 CR showed clinically relevant results with at least a moderate level of evidence. The following intervention components were estimated to be transferable and could be adapted to be part of an effective integrated care management for multimorbid chronically ill older people, specified by indications and taking identified barriers into account: (1) physical activation, (2) multidisciplinary interventions (3) interventions that enhance self-management, (4) cognitive therapy modalities, (5) telemedical interventions and (6) disease management programs.

Conclusion

The effectiveness of the identified components in frail older patients should be assessed in care-related and patient-related randomized controlled studies.

SUBMITTER: Gohner A

PROVIDER: S-EPMC7835300 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

[Integrated care management for older people with chronic diseases in domesticity: evidence from Cochrane reviews].

Göhner Anne A Bitzer Eva Maria EM Dreher Elena E Farin-Glattacker Erik E Heimbach Bernhard B Kohler Katharina K Maun Andy A Metzner Gloria G Voigt-Radloff Sebastian S

Zeitschrift fur Gerontologie und Geriatrie 20201012 1

<h4>Background</h4>The number of multiple chronically ill older people is increasing and multimorbidity is associated with high utilization of health services. Integrated care management is increasingly used to address this problem; however, there is a substantial lack of reliable data on its effectiveness in this target group.<h4>Objective</h4>To assess the effectiveness of components of integrated care management in adults of all ages and to estimate the transferability to older, multimorbid p ...[more]

PMID: 33044620

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Project description:OBJECTIVE:The World Health Organization (WHO) recently proposed an Integrated Care for Older People approach to guide health systems and services in better supporting functional ability of older people. A knowledge gap remains in the key elements of integrated care approaches used in health and social care delivery systems for older populations. The objective of this review was to identify and describe the key elements of integrated care models for elderly people reported in the literature. DESIGN:Review of reviews using a systematic search method. METHODS:A systematic search was performed in MEDLINE and the Cochrane database in June 2017. Reviews of interventions aimed at care integration at the clinical (micro), organisational/service (meso) or health system (macro) levels for people aged ?60 years were included. Non-Cochrane reviews published before 2015 were excluded. Reviews were assessed for quality using the Assessment of Multiple Systematic Reviews (AMSTAR) 1 tool. RESULTS:Fifteen reviews (11 systematic reviews, of which six were Cochrane reviews) were included, representing 219 primary studies. Three reviews (20%) included only randomised controlled trials (RCT), while 10 reviews (65%) included both RCTs and non-RCTs. The region where the largest number of primary studies originated was North America (n=89, 47.6%), followed by Europe (n=60, 32.1%) and Oceania (n=31, 16.6%). Eleven (73%) reviews focused on clinical 'micro' and organisational 'meso' care integration strategies. The most commonly reported elements of integrated care models were multidisciplinary teams, comprehensive assessment and case management. Nurses, physiotherapists, general practitioners and social workers were the most commonly reported service providers. Methodological quality was variable (AMSTAR scores: 1-11). Seven (47%) reviews were scored as high quality (AMSTAR score ?8). CONCLUSION:Evidence of elements of integrated care for older people focuses particularly on micro clinical care integration processes, while there is a relative lack of information regarding the meso organisational and macro system-level care integration strategies.

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Dataset Information

[Integrated care management for older people with chronic diseases in domesticity: evidence from Cochrane reviews].

Background

Objective

Methods

Results

Conclusion

Publications

[Integrated care management for older people with chronic diseases in domesticity: evidence from Cochrane reviews].

Similar Datasets

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