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A systematic review of intervention studies to prevent hospitalizations of community-dwelling older adults with dementia.

Phelan EA, Debnam KJ, Anderson LA, Owens SB - Med Care (2015)

Bottom Line: A significant reduction in hospital admissions was not found in any of the included studies, although 1 study did observe a reduction in hospital days.Only 1 intervention was found to have an effect on hospitalizations.Future work would benefit from strategies specifically designed to reduce and prevent acute hospitalizations in persons with dementia.

View Article: PubMed Central - PubMed

Affiliation: *Department of Medicine, School of Medicine, Division of Gerontology and Geriatric Medicine †Department of Health Services, School of Public Health, University of Washington, Seattle, WA ‡Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD §Healthy Aging Program, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA ∥Directors of Health Promotion and Education, Washington, DC.

ABSTRACT

Objectives: To conduct a systematic literature review to determine if there were any intervention strategies that had any measurable effect on acute-care hospitalizations among community-dwelling adults with dementia.

Design: Studies were identified by a professional research librarian and content experts.

Setting: Community dwelling.

Participants: Participants were diagnosed with dementia, severity ranging from mild to severe, and were recruited from health care and community agencies.

Measurements: A study met the inclusion criteria if it: (a) was published in English; (b) included a control or comparison group; (c) published outcome data from the intervention under study; (d) reported hospitalization as one of the outcomes; (e) included community-dwelling older adults; and (f) enrolled participants with dementia. Ten studies met all inclusion criteria.

Results: Of the 10 studies included, most assessed health services use (ie, hospitalizations) as a secondary outcome. Participants were recruited from a range of health care and community agencies, and most were diagnosed with dementia with severity ratings ranging from mild to severe. Most intervention strategies consisted of face-to-face assessments of the persons living with dementia, their caregivers, and the development and implementation of a care plan. A significant reduction in hospital admissions was not found in any of the included studies, although 1 study did observe a reduction in hospital days.

Conclusions: The majority of studies included hospitalizations as a secondary outcome. Only 1 intervention was found to have an effect on hospitalizations. Future work would benefit from strategies specifically designed to reduce and prevent acute hospitalizations in persons with dementia.

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Related in: MedlinePlus

Steps of systematic review. *An Endnote file of excluded articles is available from the authors upon request.
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Figure 1: Steps of systematic review. *An Endnote file of excluded articles is available from the authors upon request.

Mentions: A professional research librarian obtained articles from database searches (from 1990 through December 2013) of PubMed, CINAHL, Cochrane, Embase, PsycINFO, Wholis, Proquest, EBSCO, and WOS (see Fig. 1 for PRISMA-formatted chart with search strategy and details). Additional sources included reference lists from published studies and representatives of organizations who have published work in the area of dementia (eg, Institute of Medicine; University of California at Los Angeles). Four hundred thirty-four references were identified in this initial search. Then, through an iterative process, all authors systematically identified articles that met the inclusion criteria. See Figure 1 for details of the steps included in the systematic review, including MESH terms. This process resulted in 10 articles for analysis.17–26


A systematic review of intervention studies to prevent hospitalizations of community-dwelling older adults with dementia.

Phelan EA, Debnam KJ, Anderson LA, Owens SB - Med Care (2015)

Steps of systematic review. *An Endnote file of excluded articles is available from the authors upon request.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4310672&req=5

Figure 1: Steps of systematic review. *An Endnote file of excluded articles is available from the authors upon request.
Mentions: A professional research librarian obtained articles from database searches (from 1990 through December 2013) of PubMed, CINAHL, Cochrane, Embase, PsycINFO, Wholis, Proquest, EBSCO, and WOS (see Fig. 1 for PRISMA-formatted chart with search strategy and details). Additional sources included reference lists from published studies and representatives of organizations who have published work in the area of dementia (eg, Institute of Medicine; University of California at Los Angeles). Four hundred thirty-four references were identified in this initial search. Then, through an iterative process, all authors systematically identified articles that met the inclusion criteria. See Figure 1 for details of the steps included in the systematic review, including MESH terms. This process resulted in 10 articles for analysis.17–26

Bottom Line: A significant reduction in hospital admissions was not found in any of the included studies, although 1 study did observe a reduction in hospital days.Only 1 intervention was found to have an effect on hospitalizations.Future work would benefit from strategies specifically designed to reduce and prevent acute hospitalizations in persons with dementia.

View Article: PubMed Central - PubMed

Affiliation: *Department of Medicine, School of Medicine, Division of Gerontology and Geriatric Medicine †Department of Health Services, School of Public Health, University of Washington, Seattle, WA ‡Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD §Healthy Aging Program, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA ∥Directors of Health Promotion and Education, Washington, DC.

ABSTRACT

Objectives: To conduct a systematic literature review to determine if there were any intervention strategies that had any measurable effect on acute-care hospitalizations among community-dwelling adults with dementia.

Design: Studies were identified by a professional research librarian and content experts.

Setting: Community dwelling.

Participants: Participants were diagnosed with dementia, severity ranging from mild to severe, and were recruited from health care and community agencies.

Measurements: A study met the inclusion criteria if it: (a) was published in English; (b) included a control or comparison group; (c) published outcome data from the intervention under study; (d) reported hospitalization as one of the outcomes; (e) included community-dwelling older adults; and (f) enrolled participants with dementia. Ten studies met all inclusion criteria.

Results: Of the 10 studies included, most assessed health services use (ie, hospitalizations) as a secondary outcome. Participants were recruited from a range of health care and community agencies, and most were diagnosed with dementia with severity ratings ranging from mild to severe. Most intervention strategies consisted of face-to-face assessments of the persons living with dementia, their caregivers, and the development and implementation of a care plan. A significant reduction in hospital admissions was not found in any of the included studies, although 1 study did observe a reduction in hospital days.

Conclusions: The majority of studies included hospitalizations as a secondary outcome. Only 1 intervention was found to have an effect on hospitalizations. Future work would benefit from strategies specifically designed to reduce and prevent acute hospitalizations in persons with dementia.

Show MeSH
Related in: MedlinePlus