Models of comprehensive care for older persons with chronic diseases: a systematic review with a focus on effectiveness
Introduction Ageing entails a variety of physiological changes that increase the risk of chronic non-communicable diseases. The prevalence of these diseases leads to an increase in the use of health services. The care models implemented by health systems should provide comprehensive long-term health...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-08-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/8/e059606.full |
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| author | Leticia A Barajas-Nava Juan Garduño-Espinosa Juan M Mireles Dorantes Raúl Medina-Campos M Carmen García-Peña |
| author_facet | Leticia A Barajas-Nava Juan Garduño-Espinosa Juan M Mireles Dorantes Raúl Medina-Campos M Carmen García-Peña |
| author_sort | Leticia A Barajas-Nava |
| collection | DOAJ |
| description | Introduction Ageing entails a variety of physiological changes that increase the risk of chronic non-communicable diseases. The prevalence of these diseases leads to an increase in the use of health services. The care models implemented by health systems should provide comprehensive long-term healthcare. We conducted this systematic review to determine whether any model of care for older persons have proven to be effective.Methods A systematic review of literature was carried out to identify randomised clinical trials that have assessed how effective a care model for older patients with chronic diseases. A searches electronic databases such as MEDLINE, Turning Research Into Practice Database, Cochrane Library and Cochrane Central Register of controlled Trials was conducted from January 1966 to January 2021. Two independent reviewers assessed the eligibility of the studies. Interventions were identified and classified according to the taxonomies developed by the Cochrane Effective Practice and Organisation of Care and Cochrane Consumers and Communication groups.Results Of the 4952 bibliographic references that were screened, 577 were potentially eligible and the final sample included 25 studies that evaluated healthcare models in older people with chronic diseases. In the 25 care models, the most frequently implemented interventions were educational, and those based on the provision of healthcare. Only 22% of the outcomes of interventions were identified as being effective, whereas 21% were identified as being partially effective; thus, more than 50% of the outcomes were identified as being ineffective.Conclusions It was not possible to determine a care model as effective. The interventions implemented in the models are variable. The most effective outcomes were focused on improving the patient–healthcare professional relationship in the early stages of the intervention. The interventions addressed in the studies were similar to public health interventions as their main objectives focused on promoting health. Most studies were of low methodological quality. |
| first_indexed | 2024-04-13T11:20:55Z |
| format | Article |
| id | doaj.art-50474a3686e9472f8504635f27c73c64 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-13T11:20:55Z |
| publishDate | 2022-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-50474a3686e9472f8504635f27c73c642022-12-22T02:48:49ZengBMJ Publishing GroupBMJ Open2044-60552022-08-0112810.1136/bmjopen-2021-059606Models of comprehensive care for older persons with chronic diseases: a systematic review with a focus on effectivenessLeticia A Barajas-Nava0Juan Garduño-Espinosa1Juan M Mireles Dorantes2Raúl Medina-Campos3M Carmen García-Peña4Evidence-Based Medicine Research Unit, Hospital Infantil de México Federico Gómez (HIMFG), National Health Institute, México City, MéxicoHead of the Research Office, Hospital Infantil de México Federico Gómez (HIMFG), National Health Institute, México City, MéxicoHigh School of Medicine, Instituto Politécnico Nacional, México City, MéxicoDeputy Research Director, Instituto Nacional de Geriatría, México City, MéxicoHead of the Research Office, Instituto Nacional de Geriatría, México City, MéxicoIntroduction Ageing entails a variety of physiological changes that increase the risk of chronic non-communicable diseases. The prevalence of these diseases leads to an increase in the use of health services. The care models implemented by health systems should provide comprehensive long-term healthcare. We conducted this systematic review to determine whether any model of care for older persons have proven to be effective.Methods A systematic review of literature was carried out to identify randomised clinical trials that have assessed how effective a care model for older patients with chronic diseases. A searches electronic databases such as MEDLINE, Turning Research Into Practice Database, Cochrane Library and Cochrane Central Register of controlled Trials was conducted from January 1966 to January 2021. Two independent reviewers assessed the eligibility of the studies. Interventions were identified and classified according to the taxonomies developed by the Cochrane Effective Practice and Organisation of Care and Cochrane Consumers and Communication groups.Results Of the 4952 bibliographic references that were screened, 577 were potentially eligible and the final sample included 25 studies that evaluated healthcare models in older people with chronic diseases. In the 25 care models, the most frequently implemented interventions were educational, and those based on the provision of healthcare. Only 22% of the outcomes of interventions were identified as being effective, whereas 21% were identified as being partially effective; thus, more than 50% of the outcomes were identified as being ineffective.Conclusions It was not possible to determine a care model as effective. The interventions implemented in the models are variable. The most effective outcomes were focused on improving the patient–healthcare professional relationship in the early stages of the intervention. The interventions addressed in the studies were similar to public health interventions as their main objectives focused on promoting health. Most studies were of low methodological quality.https://bmjopen.bmj.com/content/12/8/e059606.full |
| spellingShingle | Leticia A Barajas-Nava Juan Garduño-Espinosa Juan M Mireles Dorantes Raúl Medina-Campos M Carmen García-Peña Models of comprehensive care for older persons with chronic diseases: a systematic review with a focus on effectiveness BMJ Open |
| title | Models of comprehensive care for older persons with chronic diseases: a systematic review with a focus on effectiveness |
| title_full | Models of comprehensive care for older persons with chronic diseases: a systematic review with a focus on effectiveness |
| title_fullStr | Models of comprehensive care for older persons with chronic diseases: a systematic review with a focus on effectiveness |
| title_full_unstemmed | Models of comprehensive care for older persons with chronic diseases: a systematic review with a focus on effectiveness |
| title_short | Models of comprehensive care for older persons with chronic diseases: a systematic review with a focus on effectiveness |
| title_sort | models of comprehensive care for older persons with chronic diseases a systematic review with a focus on effectiveness |
| url | https://bmjopen.bmj.com/content/12/8/e059606.full |
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