Systematic Review of Randomized Controlled Trials in Australian Nursing Homes from 2000 to 2018

Pham, Tony; Bugeja, Lyndal; Holmes, Alice; Ibrahim, Joseph

doi:10.1111/jgs.16944

Cited by 9 publications

(7 citation statements)

References 56 publications

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“…The overall risk of bias assessment of the identified RCTs found similar proportions for the three categories (low, high or unclear risk of bias). In our study, the process of personnel or participants blinding was the least fulfilled domain, similar to the evaluations in other studies of methodological assessment of RCTs in nursing (Munday et al, 2020; Pham et al, 2021), and in trends of RCTs in general (Vinkers et al, 2021). This may be due to the fact that most commonly studied interventions were educational, and their inherent nature makes them very difficult to blind (Guo et al, 2014; Loezar et al, 2018; Vinkers et al, 2021).…”

Section: Discussionsupporting

confidence: 82%

“…Nursing, like all health science disciplines, must be based on scientific evidence. Although scientific production has increased significantly in recent years (Adams et al, 2018; Baldi et al, 2014; Devos et al, 2018; Guo et al, 2014; Hodgson et al, 2014; Munday et al, 2020; Pham et al, 2021) it remains low compared to other disciplines (Alonso Coello et al, 2004; Jiménez Hernández et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

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Finding and evaluating randomised controlled trials in nursing conducted by Spanish research teams: A scoping review

Medina-Aedo

Torralba-Martínez

Segura-Carrillo

et al. 2022

Health Info Libraries J

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Background/objectives: To identify and assess the main characteristics and the potential risk of bias of randomised controlled trials (RCTs) in nursing conducted by Spanish research teams. Methods: Scoping review of an electronic search in three major databases (date of search: October 2021). For the eligible studies, both descriptive data, and data to assess the potential risk of bias, were collected and analysed. Results: Of 3391 references retrieved, 199 were eligible. These RCTs were published in 122 journals, most of them in English (101, 82.1%) and were included in the Journal Citation Report (JCR) (107, 87.7%). Moreover, 32 (26.2%) of those included in the JCR were classified under nursing. Two thirds (81, 66.4%) of the journals followed the CONSORT guidelines. A total of 65 RCTs (33.7%) had a high overall risk of bias.Discussion: Most of the identified RCTs were published in journals not specific to nursing and in English language. Also, shortcomings in RCT design and reporting were observed despite recommendations to adhere the CONSORT guidelines. Conclusion:Comprehensive identification of RCTs in nursing may require searching in journals other than nursing-related. RCTs from Spanish research teams are more likely to be published in international journals published in English. CONSORT should be strongly advised to encourage proper design and reporting of RCTs.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Finding and evaluating randomised controlled trials in nursing conducted by Spanish research teams: A scoping review

Medina-Aedo

Torralba-Martínez

Segura-Carrillo

et al. 2022

Health Info Libraries J

View full text Add to dashboard Cite

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“…The majority were conducted in the United States and had 36 diverse intervention targets, including falls, weight loss, mood, prescribing, and oral hygiene. A review of RCTs in Australian NHs identified 39 studies conducted between 2000 and 2018 13 . The majority of these studies addressed dementia care, fall prevention, and mental health or psychiatric issues.…”

Section: Discussionmentioning

confidence: 99%

“…A review of RCTs in Australian NHs identified 39 studies conducted between 2000 and 2018. 13 The majority of these studies addressed dementia care, fall prevention, and mental health or psychiatric issues. Neither of these reviews summarized the results of the studies.…”

Section: Discussionmentioning

confidence: 99%

Nursing home performance in a trial to reduce hospitalizations: Implications for future trials

Ouslander

Reyes

Yang

et al. 2021

J American Geriatrics Society

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Background Experience in trials of implementing quality improvement (QI) programs in nursing homes (NHs) has been variable. Understanding the characteristics of NHs that demonstrate improvements during these trials is critical to improving NH care. Design Secondary analysis of a randomized controlled trial of implementation of a QI program to reduce hospital transfers. Participants Seventy‐one NHs that completed the 12‐month trial Intervention Implementation included distance‐learning strategies, involvement of a champion, regular submission of data on hospitalizations and root cause analyses of transfers, and training, feedback and support. Measurements Primary outcomes included all‐cause and potentially avoidable hospitalizations and emergency department (ED) visits per 1000 NH resident days, and the percentage of residents readmitted in 30‐days. We compared multiple other variables that could influence effective program implementation in NHs in the highest versus lowest quartile of changes in the primary outcomes. Results The 18 high‐performing NHs had significant reductions in hospitalization and ED visits, whereas the 18 NHs in the low‐performing group had increases. The difference in changes in each outcome varied between a reduction of 0.75 and 2.30 events relative to a NH with a census of 100; the absolute difference in 30‐day readmissions was 19%. None of the variables we examined reached significance after adjustment for multiple comparisons between the groups. There was no consistent pattern of differences in nonprofit status, nursing staffing, and quality ratings. Conclusion Our experience and reviews of other NH trials suggest that key factors contributing to successful implementation QI programs in NHs remain unclear. To improve NH care, implementation trials should account for intervention fidelity and factors that have not been examined in detail, such as degree and nature of leadership support, financial and regulatory incentives, quality measures, resident and family perspectives, and the availability of onsite high‐quality medical care and support of the medical director.

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“…In long-term care, evidence for treatment that meets treatment goals is often sparse or less applicable to older adults with multimorbidity, 1–3 except perhaps for trialled novel stand-alone dementia-care interventions. 4 Physicians who are skilled in research in long-term care and older populations can help move the field forward in terms of professionalization and enhanced quality of care, contributing to a relevant evidence base.…”

Section: Introductionmentioning

confidence: 99%

Perceptions and Motivation Regarding Performing Research in Physicians Specializing in Care for Older Adults Involved in a Mandatory Evidence-Based Medicine Training Study: A Mixed-Methods Study

Steen¹,

Tong²,

Groothuijse³

et al. 2022

AMEP

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Purpose Evidence underpinning treatment of older persons with complex conditions is often sparse, and involving more early career physicians committed to optimizing care for older adults may help increase a relevant evidence base. We examined perception of and motivation to conduct research in physicians (residents) specializing in care of older adults. Subjects and Methods Residents of an academic medical centre in the Netherlands enrolled in a 3-year training programme. The programme includes a mandatory evidence-based medicine (EBM) training study on pain and discomfort in cognitively impaired nursing home patients, in which residents perform their research over the 3-year duration of the programme. We employed a mixed-methods design with survey and qualitative interviews (December 2019–April 2020). The survey included validated scales with agreement response options rated 1–7. Qualitative interviews were underpinned by interpretative phenomenological analysis. Results Of 38 invited residents, 23 (15 females) participated. The mean score on perceptions of research was 4.1 (SD 0.8); on intrinsic motivation 4.8 (SD 1.0); on extrinsic motivation 4.3, with a higher SD of 1.4. Eight interviews also showed diversity in the extent to which residents felt equipped to conduct the mandatory EBM training study, and research more generally, which was related to previous experiences performing research. The residents generally did not anticipate conducting research themselves despite recognizing the benefits of training in research. Conclusion Perceptions and motivation of the residents specializing in care of older people to conduct research, although considered relevant to their practice, were not very positive. The study results in recommendations to motivate physicians in geriatrics training to conduct research, eg through personalized boosting of self-efficacy. This is crucial to motivate future physicians to contribute to research relevant to older people in more ways than just delivering data for research conceived by (non-clinical) researchers.

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Systematic Review of Randomized Controlled Trials in Australian Nursing Homes from 2000 to 2018

Cited by 9 publications

References 56 publications

Finding and evaluating randomised controlled trials in nursing conducted by Spanish research teams: A scoping review

Finding and evaluating randomised controlled trials in nursing conducted by Spanish research teams: A scoping review

Nursing home performance in a trial to reduce hospitalizations: Implications for future trials

Perceptions and Motivation Regarding Performing Research in Physicians Specializing in Care for Older Adults Involved in a Mandatory Evidence-Based Medicine Training Study: A Mixed-Methods Study

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