Development of the Community-based complex Interventions to sustain Independence in Older People (CII-OP) typology: a qualitative synthesis of interventions in randomised controlled trials
Age and ageing, May 1, 2024
Additional file 1: of A multi-centre randomised trial to compare the effectiveness of geriatrician-led admission avoidance hospital at home versus inpatient admission
Standard Protocol Items Recommendations for Interventional Trials (SPIRIT) 2013 checklist recomme... more Standard Protocol Items Recommendations for Interventional Trials (SPIRIT) 2013 checklist recommended items to address in a clinical trial protocol and related documents. (DOC 121Â kb)
There is concern that existing models of acute hospital care will become unworkable as the health... more There is concern that existing models of acute hospital care will become unworkable as the health service admits an increasing number of frail older people with complex health needs, and that there is inadequate evidence to guide the planning of acute hospital level services. We aim to evaluate whether geriatrician-led admission avoidance to hospital at home is an effective alternative to hospital admission. We are conducting a multi-site randomised open trial of geriatrician-led admission avoidance hospital at home, compared with admission to hospital. We are recruiting older people with markers of frailty or prior dependence who have been referred to admission avoidance hospital at home for an acute medical event. This includes patients presenting with delirium, functional decline, dependence, falls, immobility or a background of dementia presenting with physical disease. Participants are randomised using a computerised random number generator to geriatrician-led admission avoidan...
To synthesise evidence of the effectiveness of community based complex interventions, grouped acc... more To synthesise evidence of the effectiveness of community based complex interventions, grouped according to their intervention components, to sustain independence for older people. Systematic review and network meta-analysis. Medline, Embase, CINAHL, PsycINFO, CENTRAL, clinicaltrials.gov, and International Clinical Trials Registry Platform from inception to 9 August 2021 and reference lists of included studies. Randomised controlled trials or cluster randomised controlled trials with ≥24 weeks' follow-up studying community based complex interventions for sustaining independence in older people (mean age ≥65 years) living at home, with usual care, placebo, or another complex intervention as comparators. Living at home, activities of daily living (personal/ instrumental), care home placement, and service/ economic outcomes at 12 months. Individualised care planning with tailored actions, including medicines optimisation and regular follow-ups, probably helps people to stay living at home Although some complex interventions may sustain independence, others may reduce independence Further evidence is needed about who benefits most from which kinds of interventions, which may be provided by individual participant data metaanalysis
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