4.6 Review

Self-management interventions for issues identified in a geriatric assessment: A systematic review

期刊

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
卷 70, 期 4, 页码 1268-1279

出版社

WILEY
DOI: 10.1111/jgs.17601

关键词

geriatric assessment; older adults; self-management; systematic review

资金

  1. Academic Health Sciences Centres Innovation Fund of the Ontario Ministry of Health and Long-Term Care

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Low- to moderate-quality studies have shown that there are effective self-efficacy-targeted interventions for older adults to improve various geriatric domains and related outcomes. However, the long-term effects, validation, and scalability of these interventions remain largely unknown.
Background With the development of electronic geriatric assessment (GA), recommendations for self-management can be provided to patients without the presence of health care providers. Our research question was to identify what self-management interventions can be used by patients to address issues identified in GA and to determine their effect on patient-centered outcomes such as quality of life, health, mood, cognition, and functional status. Methods Searches were conducted on July 13, 2021, by a health sciences librarian in Medline, Embase, CINAHL, PsycInfo, and the Cochrane Library. A combination of database-specific subject headings and text word searches was used such as self-management, a key word for each of the geriatric assessment domains and older adults. Two independent reviewers reviewed abstracts and full texts for inclusion and abstracted data. Narrative synthesis was used to summarize findings. Results Among 28,520 abstracts reviewed, 34 randomized controlled trials were included. The most frequently studied geriatric domains were mood (n = 13 studies), mobility/falls (n = 12), quality of life (n = 11), and functional status (n = 7). The majority of studies demonstrated positive effects on mobility/falls (9 of 12), pain (3 of 5), comorbidity (4 of 4), and medication management (4 of 4). Most studies were of low to moderate quality. All geriatric domains were targeted in at least one study. Conclusions Low- to moderate-quality studies show a variety of effective self-efficacy-targeted interventions exist for older adults to improve several important geriatric domains and related outcomes. However, long-term effects, validation, and scalability of these interventions remain largely unknown.

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