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Effects of Interprofessional Collaborative Practice in Older Adults' Hip Fractures Care: A Systematic Review and
Santo Imanuel Tonapa1,2, I-Chin Huang3, Bih-O Lee2,4,5,6
1School of Nursing, Galuh University, Ciamis, Indonesia.
Abstract:
This study aimed to evaluate the effectiveness of interprofessional collaborative practice interventions in improving activities of daily living, quality of life, length of stay, and in reducing mortality among older adults with hip fractures. Systematic review and meta-analysis of randomized controlled trials. Eight databases including AgeLine, PubMed, Embase, CINAHL Ultimate, Scopus, MEDLINE Ultimate, Web of Science, and the Cochrane Library were searched from inception to November 2025. Two reviewers independently screened studies and assessed risk of bias using Cochrane Risk-of-Bias 2.0. Random-effects meta-analyses were performed. Certainty of evidence was evaluated using GRADE. Twelve randomized controlled trials met inclusion criteria. Interventions typically involved nurses working alongside geriatricians, orthopedic surgeons, and physiotherapists within structured co-management pathways. Interprofessional collaborative practice was associated with a shorter hospital stay by a mean of 2.26 days. Activities of daily living improved by 4.86 points at 6 months and 3.92 points at 12 months on the Barthel Index. Health-related quality of life improved modestly (Hedges' G = 0.194), though this was not robust to sensitivity analysis. Mortality evidence was inconclusive at in-hospital and 6-month follow-up. Certainty of evidence ranged from very low to low across outcomes. Interprofessional collaborative practice appears to improve functional recovery and may shorten hospital stay among older adults with hip fractures, though any mortality benefit remains unproven. Clinicians should consider adopting interprofessional hip fracture pathways spanning team rounds, early mobilization, medication reconciliation, and discharge planning, while future trials clarify effects on survival. Trial Registration: PROSPERO registration number: CRD42024573834.
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