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Meta-Analysis
. 2019 Mar;33(3):395-407.
doi: 10.1177/0269215518818224. Epub 2018 Dec 12.

Goal-setting in geriatric rehabilitation: a systematic review and meta-analysis

Ewout B Smit  1 , Hylco Bouwstra  1 , Cees Mpm Hertogh  1 , Elizabeth M Wattel  1 , Johannes C van der Wouden  1
Affiliations
Meta-Analysis

Goal-setting in geriatric rehabilitation: a systematic review and meta-analysis

Ewout B Smit et al. Clin Rehabil. 2019 Mar.

Abstract

Objective:: To explore the effect of goal-setting on physical functioning, quality of life and duration of rehabilitation in geriatric rehabilitation compared to care as usual.

Data sources:: Medline, Embase, CINAHL, PsycINFO and the Cochrane Library were searched from initiation to October 2018.

Methods:: We included randomized controlled trials (RCTs), controlled before-after studies and studies using historic controls of older patients (mean age ⩾55 years) receiving rehabilitation for acquired disabilities. Our primary outcome was physical functioning; secondary outcomes were quality of life and rehabilitation duration. Cochrane guidelines were used to assess the risk of bias of the studies and extract data. Only RCT data were pooled using standardized mean difference (SMD).

Results:: We included 14 studies consisting of a total of 1915 participants with a mean age ranging from 55 to 83 years. Ten out of the 14 studies had a randomized controlled design, 7 of which could be pooled for the primary outcome. The risk of bias was judged high in several domains in all included studies. The meta-analysis showed no statistically significant differences between goal-setting and care as usual for physical functioning (SMD -0.11 (-0.32 to 0.10)), quality of life (SMD 0.09 (-0.56 to 0.75)) and rehabilitation duration (MD 13.46 days (-2.46 to 29.38)).

Conclusion:: We found low-quality evidence that goal-setting does not result in better physical functioning compared to care as usual in geriatric rehabilitation. For quality of life and duration of rehabilitation, we could not exclude a clinically relevant effect.

Keywords: Patient-centred care; geriatric rehabilitation; goal-setting; shared decision-making.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA flowchart.
Figure 2.
Figure 2.
Meta-analysis – physical functioning.
Figure 3.
Figure 3.
Meta-analysis – quality of life.
Figure 4.
Figure 4.
Meta-analysis – duration of rehabilitation.
See this image and copyright information in PMC

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