Evidence of Inter-Professional and Multi-Professional Interventions for Geriatric Patients: A Systematic Review

Abstract

Background The global utilization of health care system by older adults is increasing, parallel with an aging population [1-3]. Aging is often associated with co-morbidity and impaired functional reserve, necessitating personalized and comprehensive medical care [4-6]. The European Health Programme highlights the role of integrated care with the specific aims to improve patient experience, outcomes of care and effectiveness of health systems (known as "triple aim") through linkage or coordination of services and providers along the continuum of care [7]. In parallel, the World Health Organization emphasizes on the role of effective and sustainable collaborative network among professionals across all medical care settings, with the aims to improve health outcomes and reduce healthcare cost [8-10]. However, the exact nature of these interactions among different professions on health outcome and overall cost, is currently unclear [9, 11]. Furthermore, robust evidence on the efficacy of complex care interventions based on multi-professional teams and integrated interventions, remains scarce. Therefore, the aims of this systematic review are two folds. First, we sought to evaluate the impact of intervention based on multi-professional teamwork across care settings on the health determinants among geriatric patients. Secondly, we sought to determine the specific profession(s) which could lead to sustainable benefits for patient and health care systems. Method This systematic review was conducted according to PRISMA guidelines and was registered in PROSPERO (CRD42018097024).

The effectiveness of interventions to reduce adverse outcomes among older adults following Emergency Department discharge: umbrella review

“…One systematic review [ 15 ] was excluded on the basis of very low quality, with a critical appraisal score of 3 (Supplementary Information 4). Six systematic reviews were judged to be of low quality [ 19 , 30 , 37 , 71 , 72 ]; six were judged to be of moderate quality [ 16 , 38 , 39 , 73 – 75 ] and three were deemed high quality [ 2 , 36 , 70 ]. Criteria 11, relating to specific directives for new research, was the only criteria to be met by all 16 systematic reviews.…”

“…Of the 15 systematic reviews that underwent quality appraisal assessment using the AMSTAR 2 tool [ 66 ], none were rated high quality. One systematic review and meta-analysis was rated as moderate quality [ 2 ], while the majority ( n = 10) of the included systematic reviews were rated critically low [ 19 , 30 , 37 – 40 , 71 , 72 , 74 , 75 ]. Of note, four systematic reviews registered a protocol prior to commencement of the systematic review (Item 2) [ 2 , 16 , 36 , 71 ], a critical domain within AMSTAR 2 quality rating [ 66 ].…”

Competencies relevant for gerontological nursing: Focus-group interviews with professionals in the nursing of older people

“…RNs participate daily in multi-professional team and cooperating in different fields and organizations demand good communication skills. Multi-professional interventions has positive effects on older people's physical health and psychosocial well-being (56), so the RN should take this into account when supporting the well-being of older people. However, the RN is also responsible for counselling of the older patient and/or their family when needed, therefore it is important for the RN to be able to implement individual and customer-oriented counseling and guidance for both the patient and his or her family.…”

From the bench to practice – Field integration of community-based services for older citizens with different levels of functional limitation across European Regions

“…Building on results from the two other working groups, experts in care for very frail older people elaborated another two domains of interest to facilitate quality of care for those older people, highly in need for support and medical integrated care. Many studies suggest that a patient centered teamwork approach is essential for constructing a high quality, safe and reliable health care delivery system 20 . In this context, a capability framework of core competences for caring frail older people has been developed by experts and was adopted during this meeting 21 .…”