scholarly journals How effective is integrated care for community-dwelling frail older people? The case of the Netherlands

2016 ◽  
Vol 45 (5) ◽  
pp. 587-589 ◽  
Author(s):  
Emiel O. Hoogendijk
Keyword(s):  
The Netherlands ◽  
Older People ◽  
Integrated Care ◽  
Community Dwelling ◽  
Frail Older People

scholarly journals Untangling the inter-relatedness within integrated care programmes for community-dwelling frail older people: a rapid realist review

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043280
Author(s):  
Anam Ahmed ◽  
Maria E T C van den Muijsenbergh ◽  
Janne C Mewes ◽  
Walter P Wodchis ◽  
Hubertus J M Vrijhoef
Keyword(s):  
Older People ◽  
Integrated Care ◽  
Informal Caregivers ◽  
Realist Review ◽  
Community Dwelling ◽  
Care Process ◽  
Multidisciplinary Teams ◽  
Frail Older People ◽  
Programme Theory ◽  
Rapid Realist Review

ObjectiveTo identify the relationships between the context in which integrated care programmes (ICPs) for community-dwelling frail older people are applied, the mechanisms by which the programmes do (not) work and the outcomes resulting from this interaction by establishing a programme theory.DesignRapid realist review.Inclusion criteriaReviews and meta-analyses (January 2013–January 2019) and non-peer-reviewed literature (January 2013–December 2019) reporting on integrated care for community-dwelling frail older people (≥60 years).AnalysisSelection and appraisal of documents was based on relevance and rigour according to the Realist And Meta-narrative Evidence Syntheses: Evolving Standards criteria. Data on context, mechanisms, programme activities and outcomes were extracted. Factors were categorised into the five strategies of the WHO framework of integrated people-centred health services (IPCHS).Results27 papers were included. The following programme theory was developed: it is essential to establish multidisciplinary teams of competent healthcare providers (HCPs) providing person-centred care, closely working together and communicating effectively with other stakeholders. Older people and informal caregivers should be involved in the care process. Financial support, efficient use of information technology and organisational alignment are also essential. ICPs demonstrate positive effects on the functionality of older people, satisfaction of older people, informal caregivers and HCPs, and a delayed placement in a nursing home. Heterogeneous effects were found for hospital-related outcomes, quality of life, healthcare costs and use of healthcare services. The two most prevalent WHO-IPCHS strategies as part of ICPs are ‘creating an enabling environment’, followed by ‘strengthening governance and accountability’.ConclusionCurrently, most ICPs do not address all WHO-IPCHS strategies. In order to optimise ICPs for frail older people the interaction between context items, mechanisms, programme activities and the outcomes should be taken into account from different perspectives (system, organisation, service delivery, HCP and patient).

scholarly journals Fall Prevention in Dutch Physician Practices: A Descriptive Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 235-235
Author(s):  
Wytske Meekes ◽  
C J Leemrijse ◽  
J C Korevaar ◽  
L A M van de Goor
Keyword(s):  
The Netherlands ◽  
Older People ◽  
Fall Prevention ◽  
Fear Of Falling ◽  
Daily Practice ◽  
Health Issues ◽  
Frail Older People ◽  
Physician Practices ◽  
Important Health ◽  
Underlying Causes

Abstract Falls are an important health threat among frail older people. Physicians are often the first to contact for health issues and can be seen as designated professionals to provide fall prevention. However, it is unknown what they exactly do and why regarding fall prevention. This study aims to describe what physicians in the Netherlands do during daily practice in regards to fall prevention. About 65 physicians (34 practices) located throughout the Netherlands were followed up for 12 months. When a physician entered specific ICPC-codes related to frailty and falls in the Hospital Information System, the physician received a pop-up asking if the patient is frail. If so, the physician subsequently completed a questionnaire. The physicians completed 1396 questionnaires. More than half (n=726) of the patients had experienced a fall in the previous year and/or had a fear of falling (FOF) and 37% of these patients received fall prevention. Physicians did not know of 20% of the patients if they had experienced a fall and of 29% of the patients if they had a FOF. The three most often treated underlying causes were mobility problems, FOF and cardiovascular risk factors. The results show that physicians are not always aware of a patient’s fall history and/or FOF and that only part of these patients receives fall prevention. Hence, it might be important to develop and implement strategies for systematic fall risk screening and fall prevention provision in the primary care setting to reduce falls among frail older people.

Effectiveness of exercise interventions on physical function in community-dwelling frail older people

2018 ◽  
Vol 16 (3) ◽  
pp. 752-775 ◽  
Author(s):  
Agathe D. Jadczak ◽  
Naresh Makwana ◽  
Natalie Luscombe-Marsh ◽  
Renuka Visvanathan ◽  
Timothy J. Schultz
Keyword(s):  
Older People ◽  
Physical Function ◽  
Community Dwelling ◽  
Frail Older People ◽  
Exercise Interventions
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