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首页> 外文期刊>The journals of gerontology.Series A. Biological sciences and medical sciences >Multidimensional preventive home visit programs for community-dwelling older adults: a systematic review and meta-analysis of randomized controlled trials.
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Multidimensional preventive home visit programs for community-dwelling older adults: a systematic review and meta-analysis of randomized controlled trials.

机译：针对社区居民老年人的多维预防性家庭访问计划：对随机对照试验的系统评价和荟萃分析。

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BACKGROUND: Multidimensional preventive home visit programs aim at maintaining health and autonomy of older adults and preventing disability and subsequent nursing home admission, but results of randomized controlled trials (RCTs) have been inconsistent. Our objective was to systematically review RCTs examining the effect of home visit programs on mortality, nursing home admissions, and functional status decline. METHODS: Data sources were MEDLINE, EMBASE, Cochrane CENTRAL database, and references. Studies were reviewed to identify RCTs that compared outcome data of older participants in preventive home visit programs with control group outcome data. Publications reporting 21 trials were included. Data on study population, intervention characteristics, outcomes, and trial quality were double-extracted. We conducted random effects meta-analyses. RESULTS: Pooled effects estimates revealed statistically nonsignificant favorable, and heterogeneous effects on mortality (odds ratio [OR] 0.92, 95% confidence interval [CI], 0.80-1.05), functional status decline (OR 0.89, 95% CI, 0.77-1.03), and nursing home admission (OR 0.86, 95% CI, 0.68-1.10). A beneficial effect on mortality was seen in younger study populations (OR 0.74, 95% CI, 0.58-0.94) but not in older populations (OR 1.14, 95% CI, 0.90-1.43). Functional decline was reduced in programs including a clinical examination in the initial assessment (OR 0.64, 95% CI, 0.48-0.87) but not in other trials (OR 1.00, 95% CI, 0.88-1.14). There was no single factor explaining the heterogenous effects of trials on nursing home admissions. CONCLUSION: Multidimensional preventive home visits have the potential to reduce disability burden among older adults when based on multidimensional assessment with clinical examination. Effects on nursing home admissions are heterogeneous and likely depend on multiple factors including population factors, program characteristics, and health care setting.
机译：背景：多维预防性家访计划旨在维持老年人的健康和自主权，并防止残疾和随后的疗养院入院，但随机对照试验（RCT）的结果一直不一致。我们的目标是系统地审查RCT，以检查家访计划对死亡率，疗养院入院率和功能状态下降的影响。方法：数据来源为MEDLINE，EMBASE，Cochrane CENTRAL数据库和参考文献。审查研究以鉴定RCT，这些RCT将预防性家庭访问计划中老年参与者的结局数据与对照组的结局数据进行了比较。包括报告21个试验的出版物。有关研究人群，干预特征，结局和试验质量的数据是双倍提取的。我们进行了随机效应荟萃分析。结果：合并效应估计显示对死亡率的统计学上无统计学意义的有利且异质性（优势比[OR] 0.92，95％置信区间[CI]，0.80-1.05），功能状态下降（OR 0.89，95％CI，0.77-1.03） ）和疗养院入院（OR 0.86，95％CI，0.68-1.10）。在较年轻的研究人群（OR 0.74，95％CI，0.58-0.94）中观察到了对死亡率的有益影响，但在较老的人群中（OR 1.14，95％CI，0.90-1.43）没有看到死亡率的有益影响。在包括初始评估中的临床检查在内的程序中，功能下降有所减少（OR 0.64，95％CI，0.48-0.87），但在其他试验中却没有减少（OR 1.00，95％CI，0.88-1.14）。没有单一因素可以解释试验对疗养院入院率的异质性影响。结论：基于临床检查的多维评估，多维预防性家庭访问有可能减少老年人的残疾负担。对疗养院入院的影响是多种多样的，并且可能取决于多种因素，包括人口因素，计划特征和医疗设置。

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