What integrated care means from an older person’s perspective? A scoping review protocol

Abstract

IntroductionAccording to the 2013 WHO Global Forum on Innovation for Ageing Populations, disabilities and morbidities associated with ageing could be minimised by accessing preventive care. One way of improving the management of multimorbidity in the older population is through the provision of ‘integrated care’. Although integrated care means different things to different people, it typically symbolises continuity in care, thus preventing older patients' from falling through gaps in the health care system. Many initiatives have attempted to improve the integration of care; however, these are typically designed from a particular policy or system perspective. Relatively little is known about patient expectations and experiences of integrated care, which is vital for developing and implementing better models of care. The proposed scoping review aims to map literature on older patients'’ views, expectations, experiences and perspectives of integrated care.Methods and analysisMultiple electronic databases including PubMed, Web of Science, Embase, PsychInfo, Google Scholar, Cochrane Library, CINAHL and ProQuest Dissertations will be searched for appropriate articles between August and December 2017. Reference lists of selected articles will also be searched for similar articles. Two experienced researchers will conduct an initial search of the literature to identify relevant articles. Abstracts of the identified articles will be reviewed collectively by two researchers to identify potential further studies. Full texts of the potential studies will be sourced and screened for the inclusion criteria. Appropriate qualitative and quantitative methods will be used to extract data from each included study.Ethics and disseminationThe scoping review will synthesise findings from studies reporting on patients’ views and expectations of integrated care. This review expects to find information relating to facilitators and barriers of integrated care from an older person’s perspective. The findings from the review will be applied when working with stakeholders representing older people, healthcare, aged care and community providers, researchers and policy makers to develop and evaluate a more locally tailored and person-centred approach to integrated care.

What does integrated care mean from an older person’s perspective? A scoping review

“…Scoping reviews are used to understand the existing breadth of research on a topic, identify gaps in existing literature and assess the need for further investigation 13 14. The scoping review methodology outlined by Arksey and O’Malley13 was employed, details of which are published in our protocol 12. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews checklist15 was used to guide reporting.…”

“…MMM performed the initial search in four electronic databases (EMBASE, CINAHL, PubMed and ProQuest) and two grey literature databases (Open Grey and Google Scholar). Studies published from June 2008 to July 2019 in English language were included to ensure feasibility and relevance to the current healthcare context, that is, studies conducted after the publication of a consensus definition of integrated care by the WHO 12. No limitations were placed on study design, type of healthcare setting, geographical location, or the upper age and gender of the participants.…”

“…A local advisory group working with older adults was engaged periodically during the review process 12. To ensure a patient-centred approach and to facilitate the application of the review findings, results will be disseminated among patients, carers and other stakeholders and presented at public forums.…”

“…To our knowledge, no evidence synthesis has summarised the available literature on older adults’ views and expectations regarding integrated or similarly coordinated care. Starting with a focus on patient experiences rather than single-organisation or single-sector solutions,8 this review forms part of a larger programme of research that aims to coproduce and implement locally relevant approaches to improve integrated care for older adults at risk of repeated hospitalisation guided by a person-centred approach 11 12…”

“…The review protocol has been published previously12 and sets out a plan to address the following questions:…”