基于社区的复杂干预措施,以维持老年人的独立性:系统审查和网络元分析
Thomas F Crocker1, Joie Ensor2,3, Natalie Lam4
1Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK medtcro@leeds.ac.uk.
概括
个性化护理规划,包括药物审查和定期后续检查,是维持老年人独立性的最有效方法. 一些干预组合可能会意外地降低独立性,需要进一步研究.
科学领域:
- 老年学与公共卫生
- 证据综合和元分析
背景情况:
- 年长的成年人在家庭中保持独立面临挑战.
- 基于社区的复杂干预旨在支持独立性,但其有效性各不相同.
研究的目的:
- 综合证据,以社区为基础的复杂干预措施的有效性,以维持老年人的独立性.
- 将干预按组件分组,以确定最佳策略.
主要方法:
- 对129项随机对照试验 (74946名参与者) 的系统综述和网络元分析.
- 干预措施使用开发的类型学来分类.
- 使用GRADE和ROB 2工具评估了偏差风险和证据确定性.
主要成果:
- 从个性化护理计划的多因素行动,包括药物审查和定期后续检查,有利于维持独立性 (OR 1.22,中等确定性).
- 具体的组合显示,对日常生活活动和家庭护理接受者的活动有潜在的益处.
- 偏差的高风险和不准确的估计导致大多数发现的确定性低或非常低.
结论:
- 以药物优化和定期审查为基础的个性化护理规划是维持老年人独立性的最有前途的干预措施.
- 家庭护理接收者可能特别受益于这种定制方法.
- 进一步的研究是必不可少的,以确定最佳的干预组合,以满足不同的人群和环境.
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