Reducing unplanned hospital admissions from care homes: an updated and extended systematic review
Award Number
NIHR133884Programme
Health and Social Care Delivery ResearchStatus / Stage
CompletedDates
11 January 2021 -10 January 2022
Duration (calculated)
00 years 11 monthsFunder(s)
NIHRFunding Amount
£94,859.20Funder/Grant study page
NIHRContracted Centre
The University of SheffieldContracted Centre Webpage
Principal Investigator
Mr Duncan ChambersPI Contact
d.chambers@sheffield.ac.ukPI ORCID
0000-0002-0154-0469WHO Catergories
Methodologies and approaches for risk reduction researchDisease Type
Dementia (Unspecified)CPEC Review Info
| Reference ID | 31 |
|---|---|
| Researcher | Reside Team |
| Published | 12/06/2023 |
Data
| Award Number | NIHR133884 |
|---|---|
| Status / Stage | Completed |
| Start Date | 20210111 |
| End Date | 20220110 |
| Duration (calculated) | 00 years 11 months |
| Funder/Grant study page | NIHR |
| Contracted Centre | The University of Sheffield |
| Contracted Centre Webpage | |
| Funding Amount | £94,859.20 |
Abstract
Care home residents include many people with complex health and care needs and are at high risk of experiencing unplanned hospital admissions. While they are sometimes appropriate, such admissions can be costly for the NHS and distressing for the residents, their families and friends, and care home staff. Interventions to reduce unplanned admissions may be implemented at various points in the health and social care system. In 2014, the University of York Centre for Reviews and Dissemination (CRD) published an evidence briefing on the topic for health service commissioners. We propose to update and extend their work. The overall research questions are: What interventions are used in the UK health and social care system to minimise unplanned hospital admissions of care home residents? What candidate interventions, used in other high-income countries, could potentially be used in the UK? What can we learn from research studies and ‘real-world’ evaluations about the effects of such interventions on admissions? What is known about the feasibility of implementing such interventions in routine practice and their acceptability to care home residents and staff? What is known about the costs and value for money associated with these interventions? The aim of this project is to carry out a systematic evidence review of interventions to reduce unplanned hospital admissions of residents in care homes (including nursing homes) for older people. Supporting objectives are to perform the review using rigorous methods and to involve the public and care home staff throughout. Rigorous systematic review methods will be used throughout, including a robust search strategy, duplicate selection of studies for inclusion, and assessment of risk of bias. A provisional taxonomy of relevant interventions is included in the proposal. Our proposal emphasises the importance of describing interventions in detail (using the TiDiER-LIte checklist). We will not limit inclusion by study design and will include UK ‘grey’ literature. Given the nature of the review question and the diverse interventions potentially included, we anticipate performing a narrative synthesis. However, we will use meta-analysis to synthesise evidence where appropriate. Overall strength of evidence for each intervention will be classified as ‘stronger’, ‘weaker’, ‘very limited’ or ‘inconsistent’, based on the number and design of relevant studies. Evidence on effectiveness will be considered alongside that on feasibility, acceptability and ‘cost-effectiveness’ to provide an overall assessment of the intervention. We propose to conduct the review over 11 months, starting in November 2021. A timetable is included in the research plan. We will identify and communicate the implications of the review findings for key stakeholders including health and social care commissioners, care home staff and residents, members of their social networks and the public. We will develop diverse outputs to meet the needs of different audiences in digital and printed formats. The study report and other outputs will offer a resource for decision-makers considering which evidence-based interventions may be appropriate for use in their setting. We will identify areas of limited evidence and provide clear recommendations to support the HS&DR programme and other funders in commissioning new research
Aims
The aim of this project is to carry out a systematic evidence review of interventions to reduce unplanned hospital admissions of residents in care homes (including nursing homes) for older people. Supporting objectives are to perform the review using rigorous methods and to involve the public and care home staff throughout.