Background
Key outcomes | ||
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● | Prevention of unnecessary hospital admission | ●Management of medication at home |
● | Prevention of delayed discharge from hospital | ●Delivery of community nursing |
● | Reducing lengths of hospital stay | ●Carer support |
● | Effective discharge from hospital | ●Self directed support |
● | Consistency and quality of home care delivery (including staff training, staff support) |
Methods
Search and selection strategy
Literature review search terms (‘*’ denotes truncation symbol)
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(dementia OR Alzheimer*) and (care OR support) and (hospital admission*)
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(dementia OR Alzheimer*) and (care OR support) and (discharge*) [note: delayed, effective, supported discharge all covered by this string]
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(dementia OR Alzheimer*) and (care OR support) and (hospital stay*)
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(dementia OR Alzheimer*) and ((home OR domiciliary) AND (care OR support)) and (staff)
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(dementia OR Alzheimer*) and ((home OR domiciliary) AND care) and (hours OR evening* OR overnight OR weekend*) [from Care of Older People Information Set (COPIS)†]
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(dementia OR Alzheimer*) and (home) and (medicine* OR medicat*) and (management OR compliance OR adherence OR capacitance)
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(dementia OR Alzheimer*) and (community nurs*)
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(dementia OR Alzheimer*) and (carer*) and (support*)
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(dementia OR Alzheimer*) and ((direct payment*) OR (self directed OR self-directed) OR (indiv* budget*))
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(dementia OR Alzheimer*) and (personalisation OR personalization)
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(dementia OR Alzheimer*) and ((reablement OR re-ablement) OR (rehabilitation) OR (enablement))
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(dementia OR Alzheimer*) and ((intermediate care) OR (rapid response) OR (step up step down) OR (convalesc*) OR (progressive care) OR (hospital-at-home))
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(dementia OR Alzheimer*) and ((community OR local OR cottage) AND (hospital*))
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(dementia OR Alzheimer*) and ((post diagnos*) OR (post-diagnos*))
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(dementia OR Alzheimer*) and (day service*)
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(dementia OR Alzheimer*) and (community support)
Review and evaluation strategy
Results
Topic | Subtopic | Items classified as high quality (study types) | Items classified as medium quality (study types |
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Early intervention and post diagnostic services | Early intervention (anticipatory/on diagnosis) | 19 (11 Literature reviews; 1 Cohort study; 7 Other (2 Program descriptions; Practice guidelines; test of MCI screening tools; Practice-based reflection; Policy analysis; Program evaluation)) | 18 (12 Literature reviews; 1 Economic evaluation; 3 Qualitative studies; 2 Other (Descriptive service overview, report of survey)) |
Post diagnostic support | 18 (9 Literature reviews; 1 Controlled clinical trial (CCT); 3 Qualitative studies; 5 Other (2 Program descriptions; practice-based reflection; Retrospective case review; Program evaluation)) | 23 (7 Literature reviews; 1 Randomised controlled trial (RCT); 2 Controlled clinical trials (CCT); 3 Qualitative studies; 1 Non-controlled Before and After study; 5 Other (2 Cross-sectional studies; 2 Service overviews; 2 Reports of surveys; Program evaluation; 2 Retrospective case reviews; Study protocol)) | |
Community-based services supporting people with dementia living in their own homes | Self directed support | 3 (1 Literature review; 1 Qualitative study; 1 Other (practice-based reflection)) | 3 (1 Literature review; 2 Other (Reports of survey; Program evaluation)) |
Community-based support | 16 (5 Literature reviews; 1 Controlled clinical trial (CCT); 4 Qualitative studies; 6 Other (Multi-method study; 2 Program evaluations; Practice-based reflection; Report of survey; Policy analysis)) | 14 (5 Literature reviews; 1 Controlled clinical trial (CCT); 1 Economic evaluation; 7 Other (Cross-sectional study; Service evaluation; Program evaluation; 2 Reports of surveys; Service description; Study protocol)) | |
Domiciliary support | 11 (3 Literature reviews; 1 Controlled clinical trial (CCT); 4 Qualitative studies; 3 Other (Report of survey; Program evaluation; Policy analysis)) | 16 (5 Literature reviews; 3 Qualitative studies; 8 Other (2 Cross-sectional studies; 2 Reports of surveys; Program evaluation; Service evaluation; Service overview; Study protocol)) | |
Rapid response | 4 (1 Literature review; 3 Other (Report of survey; Program evaluation; Retrospective case review)) | 4 (1 Qualitative study; 3 Other (Report of survey; Program evaluation; Service evaluation)) | |
Enablement, re-ablement and rehabilitation | 16 (11 Literature reviews; 2 Qualitative studies; 3 Other (Report of survey; Program description; Program evaluation)) | 18 (13 Literature reviews; 1 Qualitative study; 5 Other (Retrospective case review; Program evaluation; 2 Reports of surveys)) | |
Managing medication | 4 (1 Literature review; 1 Controlled clinical trial (CCT); 2 Qualitative studies) | 7 (2 Literature reviews; 5 Other (Service evaluation; Service description; Study protocol; Report of survey; Retrospective drug use study)) | |
Day services | 6 (4 Literature reviews; 2 Qualitative studies) | 2(2 Other (Cross-sectional study; Report of survey) | |
Hospital-related areas of interest | Intermediate care | 8 (4 Literature reviews; 1 Controlled clinical trial (CCT); 1 Qualitative study; 2 Other (Multi-method study; Policy analysis)) | 4 (1 Literature review; 1 Qualitative study; 2 Other (Program evaluation; Report of survey)) |
Preventing unnecessary admission | 13 (8 Literature reviews; 2 Qualitative studies; 3 Other (Case study; 2 Program evaluations)) | 10 (2 Literature reviews; 1 Qualitative study; 7 Other (Cross-sectional study; Service evaluation; Program evaluation; Retrospective case review; Report of survey; Service description; Study protocol)) | |
Community hospitals | 4 (2 Literature reviews; 2 Other (Retrospective case review; Program evaluation)) | 2 (2 Other (Report of a survey; Program evaluation) | |
Reductions in length of stay | 6 (3 Literature reviews; 1 Cohort study; 2 Other (2 Program evaluations)) | 5 (1 Cohort study; 4 Other (2 Retrospective case reviews; Report of survey; Program evaluation)) | |
Discharge | 5 (1 Literature review; 1 Cohort study; 3 Other (Multi-method study; 2 Program evaluations)) | 6 ((1 Literature review; 1 Cohort study; 1 Qualitative study; 3 Other (Cross-sectional study; Report of survey; Program evaluation)) | |
Informal/unpaid care | 27 (13 Literature reviews; 1 Controlled clinical trial (CCT); 6 Qualitative studies; 7 Other (Case study; Literature-based concept analysis; Meta-analysis; Multi-method study; Retrospective case review; Policy analysis)) | 25 (11 Literature reviews; 1 Randomised controlled trial (RCT); 1 Controlled clinical trial (CCT); 3 Qualitative studies; 9 Other (2 Cross-sectional studies; Study protocol; 3 Service descriptions; 2 Reports of surveys; Program evaluation)) | |
Workforce and service delivery* | |||
Joint working/ partnership working | 16 (7 Literature reviews; 1 Controlled clinical trial (CCT); 4 Qualitative studies; 4 Other (Report of survey; 2 Program evaluations; Policy analysis)) | 11 (3 Literature reviews; 3 Qualitative studies; 5 Other (Cross-sectional study; Study protocol; Service description; Report of survey; Program evaluation)) | |
Integrated care/ teams | 16 (7 Literature reviews; 1 Controlled clinical trial (CCT); 4 Qualitative studies; 4 Other (Report of survey; 2 Program evaluations; Policy analysis)) | 11 (3 Literature reviews; 1 Non-controlled Before and After study; 2 Qualitative studies; 5 Other (Cross-sectional study; Study protocol; Service description; Report of survey; Program evaluation)) | |
Consistency and quality of home care (staff training and support) | 10 (2 Literature reviews; 4 Qualitative studies; 4 Other) | ||
(Literature-based concept analysis; Report of survey; Program evaluation; Policy analysis)) | 15 (7 Literature reviews; 1 Economic evaluation; 2 Qualitative studies; 5 Other | ||
(Study protocol; Service description; 2 Reports of surveys; Program evaluation) | |||
Delivery of community nursing | 5 (2 Literature reviews; 2 Qualitative studies; 1 Other) | ||
(Policy analysis) | 6 (2 Literature reviews; 4 Other | ||
(Service evaluation; Study protocol; 2 Reports of surveys) |