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Meta-Analysis
. 2005 Sep;51(9):1244-5.

Effectiveness of preventive primary care outreach interventions aimed at older people: meta-analysis of randomized controlled trials

Jenny Ploeg  1 , John Feightner, Brian Hutchison, Christopher Patterson, Christopher Sigouin, Mary Gauld
Affiliations
Meta-Analysis

Effectiveness of preventive primary care outreach interventions aimed at older people: meta-analysis of randomized controlled trials

Jenny Ploeg et al. Can Fam Physician. 2005 Sep.

Abstract
in English, French

Objective: To determine the effectiveness of preventive primary care outreach interventions aimed at older people. Knowing whether such interventions are effective could help busy family physicians make choices about which preventive care services to provide.

Data sources: We searched MEDLINE, CINAHL, AgeLine, Cochrane Controlled Trials Register, and EMBASE databases and reviewed the reference lists of retrieved articles.

Study selection: We included studies of preventive primary care interventions aimed at patients 65 years and older if the studies were randomized controlled trials and if any of the following outcomes was reported: mortality, living in the community, admission to acute care hospitals, and admission to long-term care. We defined preventive primary care outreach as proactive, provider-initiated care, which can be provided by nurses, physicians, other professionals, or volunteers, that is in addition to usual care and is provided in primary care settings. Such care can be provided through home visits, office visits, telephone contacts, or a combination of these methods.

Synthesis: We assessed the quality of studies and extracted descriptive information on study populations, interventions, and outcomes for 19 trials involving 14,911 patients. Summary odds ratios were estimated for each outcome using a random effects model.

Conclusion: This review showed that studies of preventive primary care outreach interventions aimed at older people were associated with a 17% reduction of mortality and a 23% increased likelihood of continuing to live in the community.

OBJECTIF: Évaluer l’efficacité des interventions de proximité de nature préventive effectuées auprès des personnes âgées dans un contexte de soins primaires. Connaissant l’efficacité de ces interventions, le médecin de famille surchargé pourrait mieux déterminer quel type de mesures préventives offrir.

SOURCE DES DONNÉES: On a consulté les bases de données MEDLINE, CINAHL, AgeLine, Cochrane Controled Trials Register et EMBASE et on a examiné les références bibliographiques des articles repérés.

CHOIX DES ÉTUDES: On a conservé les études retenues qui traitaient des interventions de nature préventives auprès de patients de 65 ans et plus, pourvu qu’il s’agisse d’essais randomisés avec témoins incluant au moins une des issues suivantes: décès, vie dans le milieu naturel, hospitalisation pour soins aigus et admission en centre d’hébergement à long terme. Par interventions de proximité de nature préventive nous entendons les soins proactifs entrepris à l’initiative des soignants, infirmières, médecins, autres professionnels ou bénévoles, dispensés dans un contexte de soins primaires mais ne faisant pas partie des soins habituels. Ces interventions peuvent se faire à l’occasion de visites à domicile, de consultations au bureau, de contacts téléphoniques ou d’une combinaison de ces méthodes.

SYNTHÈSE: Après avoir évalué la qualité des études, nous avons relevé l’information descriptive sur les populations étudiées, les interventions et les issues pour 19 essais incluant 14 911 patients. Pour chaque issue, les rapports de cotesglobaux ont été estimés à l’aide d’un modèle à effets aléatoires.

CONCLUSION: Cette étude montre que les interventions de proximité de nature préventive effectuées auprès des personnes âgées dans un contexte de soins primaires s’accompagnent d’une réduction de 17% de la mortalité et d’une augmentation de 23% de la probabilité de demeurer dans le milieu naturel.

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Conflict of interest statement

Competing interests: None declared

Figures

Figure 1
Figure 1
Study Flow
See this image and copyright information in PMC

References

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