Table 1 Summary of Included Studies - Patient, Staff and Setting Characteristics
First Author, Publication Year Region | Design | Sample Size | Setting | Staff Mix | Sample Characteristics (At the time of admission to TCP) | |||||
|---|---|---|---|---|---|---|---|---|---|---|
Age [Mean (Range or SD)] | Female (%) | Multimorbidity [%, Mean (Range or SD)] | Cognitive Status [Mean (Range or SD)] | Function [Mean (Range or SD)] | Living Arrangement | |||||
Abrahamsen, 2014 [18] Europe | Prospective cohort study | 557 | LTCH/NH | Geriatrician, physician, nurses, PT & OT | Median: 86 | 70 | 61% | MMSE: mean: 26 (8–30) | BI: 15 (4–20) | 74% alone |
Abrahamsen, 2016 [19] Europe | Prospective, cohort study | 961 | LTCH/NH | Nursing, OT, PT, SW & dietitian | 85 | 68.4 | 59% | MMSE: 26 (8–30) | BI: 75 (10–100) | 67% alone |
Anderson, 2005 [20] US | Retrospective, medical record audit | 68 | Community hospital | Nursing, PT, OT, SLP, dietitian. If needed, respiratory therapy | 79.7 | 64.7 | Majority had 8 conditions | Most patients oriented to the environment; 50% had intact STM | NR | 26% alone 57.3% with someone 7.4% seniors housing |
Bergman-Evans, 2010 [21] US | Retrospective cohort study | 1430 | SNF | NPs, physicians, SW, | 78 | 64 | Average # of medications: 10.1 | NR | NR | NR |
Blewett, 2010 [22] US | Multi-method non-randomized experimental study | 339 | SNF | Geriatrician, geriatric NP, geriatric pharmacist, nursing, dietitian, SW, therapeutic recreation & spiritual care | 76.8 | 66 | NR | NR | NR | NR |
Bowcutt, 2000 [23] US | Randomized controlled trial | 191 | Subacute unit inside University hospital | Geriatric CNS, nurses, dietitian, PT, OT, SLP, hearing therapist, SW, activity specialist, chaplain, physicians. | 72.9 | 61.8 | NR | Had to be mentally alert | NR | NR |
Brusco, 2012 [24] Australia | Prospective cohort study | 696 | Hospital ward, residential care facility, Community i.e., patients’ homes | PT, physicians, nursing & other allied health and support services staff | 81.9 (8.7) | 59.5 | CCI: 1.7 (1.8) | NR | BI: 60.4 (28.9) | NR |
Burke, 2015 [25] US | Retrospective survey analysis | 2.99 million | SNF | NA | 76.7 | 63 | NR | NR | NR | NR |
Buurman, 2016 [26] US | Prospective cohort study | 394 | SNF | Rehabilitation staff-not clearly reported | 84.9 | 67.8 | Had 2 or more medical conditions. | MMSE < 24: 25.6% | No. of disabilities: 6 (2–9) | 48.2% alone |
Chan, 2019 [27] Australia | Retrospective cohort study | 369 | LTCH/NH | Geriatrician, RN, PT, OT & SW | 82.9 (SD 7.84) | 64.80 | CCI: 2.5 (2.1) | 23.6% had Cognitive impairment; 10% had dementia diagnosis | Baseline BI Mean (SD): 64.0 (58.7) | 58.3% alone |
Crotty, 2005 [28] Australia | Randomized controlled trial | 317 | Transitional care facility | Pharmacist, geriatrician, rehabilitation medicine physician, PT, SW, GP, nursing, other allied health staff & a transitional care nurse coordinator | 83.0 (7.2) | 49 | NR | NR | BI: CG - 50.5 (29.7); IG - 45.8 (30.7) | NR |
Dahl, 2015 [29] Europe | Nonrandomized observational study | 328 | Intermediate care hospital | Nurses, OT, PT & physician | 75.5 | 56.5 | 4.2 (2.0) | NR | 17 ADL TCP: 1.95 (0.74) CG: 1.95 (0.82) | NR |
DelGiudice, 2009 [30] Europe | Retrospective cohort study | 375 | Acute care ward | Physicians (geri, neuro, rehab, surgery and other specialists); nursing, PT, SLP, dietitian, SW & nurses | 80.5 | 51.7 | 22.5%: 0–2 conditions; 73.5%: 3–5; 4.1%: 6–8 conditions | Moderate/severe: 16.3% Low/none: 83.7% | Katz (ADL): 63.3% dependent; 36.7% self-sufficient Lawton (IADL): Dependent: 65.1 Self-sufficient: 31 No data: 4 | NR |
Dixon, 2010 [31] Europe | Case study | 403 | Intermediate care | PT, OT, and therapy assistants, with a large range of other staff that varies greatly. | Median: 82.14 | 74.2 | NR | NR | BI: 15.00 (3–20) | NR |
Elbourne, 2012 [32] Europe | Case study | n = 94 service users n = 12 staff | 20 bed facility within a total care living complex | Nurses, care workers, PT, OT, SW & doctors | NR | NR | NR | NR | NR | NR |
*Garåsen, 2007 [33]; Garåsen, 2008 [34] Europe | Randomized controlled trial | 142 | LTCH/NH | trained nurses, general practitioners | 80.6 | 72.2 | NR | NR | ADL Score: TCP: 2.24 (0.9); CG: 2.05 (0.7) | 22% lived with spouse |
*Griffiths, 2001 [35]; Harris, 2005 [36] Europe | Randomized controlled trial | 176 | General hospital | PT, OT, NPs, nurses, clinical nurse specialists, chiropodist, doctors, dietician, SLP, SW. | 78.3 | 67 | NR | NR | Barthel index BI = 12.3 | NR |
Heim, 2016 [37] Europe | Action research project | 1933 | Community hospital and nursing home | Multidisciplinary team including geriatrician, geriatric trained nurses and physiotherapists | 78.5 | 52.95 | NR | NR | ADL limitations prior to admission frail: 36.9; 29.5 non-frail: 3.3; 3.9 | NR |
Herfjord, 2014 [38] Europe | parallel group Randomized controlled trial | 376 | LTCH/NH | physician (specialist in geriatric medicine and internal medicine/junior doctor supervised by a geriatrician), skilled nurse, physiotherapist, health care worker | 83.6 (70–96) | 73.2 | NR | no severe dementia, delirium (but staff not specified how to assess delirium or dementia) | BI = 70.0 medical: 80.0 ortho: 56.7 | NR |
Hilton, 2013 [39] Europe | Retrospective cohort study | 100 | LTCH/NH | Nursing, staff psychiatrist, PT, OT, psychologist. Visiting senior medical support included a GP, a psychiatrist, and a geriatrician | 82.6 | 65 | NR | NR | NR | NR |
Lee, 2011 [40] Asia | Non-randomized intervention cohort study | 245 | Community hospital | “Interdisciplinary geriatric team” | 82.7 (5.5) | NR | NR | MMSE: 13.4 +/− 8.1 | BI: 47.1 +/− 33.6 Lawton-Brody IADL: 2.1 +/− 2.4 | NR |
Lee, 2012 [41] Asia | Prospective cohort study | 83 | Community hospital | Interdisciplinary team | 80.3 | 3.60% | NR | Persons with severe dementia excluded | BI 35.0 +/− 21.3 | 59.3% alone |
Lees, 2013 [42] Europe | Mixed methods triangulation approach | 9 | Purpose built interim (transitional) care unit | Nurses, geriatrician, health care assistants | 75.1 | 40% | 3–8 | NR | NR | NR |
Levin, 2019 [43] Europe | Quasi experimental, interrupted time series | 107,022 | LTCH | Care home providers, SW, hospital ward staff, GP, community teams of allied health professionals, social housing associations | 81.7 (5.7) | 64.5 | NR | NR | NR | NR |
Likourezos, 2002 [44] US | Prospective cohort study | 164 | LTCH/NH | Physicians, ethics consultation team, radiology, orthopedic, dental, eye, and other specialty clinics, PT, OT, SLP | 81 (61–103) | 76.8 | CCI: 1.0 (0–4) | FIM Cognitive score 30 (range: 9–35) | FIM Motor score 46.5 (13–78) | NR |
Luthy, 2007 [45] Europe | Prospective cohort study | 166 | General medicine ward | Physicians, nurses, psychiatrists, psychologist, PT, OT & SW | 74.6 (15.6) | 52 | CCI: 3.6 (1.9) | NR | Number of ADL impairment: 2.0 (1.9) Number of IADL impairments: 2.8 (1.5) | 55% alone |
Manville, 2014 [46] Canada | Retrospective chart review | 135 | Acute care hospital | Nursing, PT/OT, rehabilitation aides, nutritionist, pharmacist. FPs (with care of the elderly training), | 86.4 | 63 | CCI: 3.16 | 51% had dementia diagnosis | NR | 55% alone |
*Michael, 2005 [47]; Michael, 2004 [48] Australia | Pre-test post-test | 168 | Acute care hospital | Nurses, therapy assistants, geriatrician, allied health services: pharmacy, PT, OT, SW, SLP & clinical psychology | 81.38 | 84 | NR | Persons with dementia and severe CI were excluded | BI: 87.3 (12.7) | 51.8% alone 45.8% with others |
Nakanishi, 2016 [49] Asia | Retrospective cohort study | 9992 | Acute care hospitals, community hospitals, LTCH/NH & patients’ own homes | NR | 85.4 | 70.5 | NR | Dementia: 24.8% | NR | |
O’Brien, 2017 [50] Canada | Pre-test post-test | 49 | LTCH/NH | physician, OT, PT, SW, dietician, nurse, & recreation specialist | 83 (66–96) | 71.4 | Moderate to severe cognitive impairment Frequent, uncontrolled inappropriate behaviors were excluded | NR | BI: 54.20 (SD = 19.26) | NR |
Orvik, 2016 [51] Europe | Retrospective and prospective multimethod observational study | 88 | LTCH/NH | nurses, physician & PT | NR | NR | NR | Persons with dementia excluded | NR | NR |
Parsons, 2002 [52] US | Retrospective chart review | 154 | Acute care hospital | Physicians, nurses, pharmacists, SW, PT, OT & NPs | 76 | 3 | Average 4 comorbidities | NR | 40% dependent in all ADLs; whereas 26% independent in all ADLs. | 62% lived with caregivers |
Richardson, 2001 [53] Europe | Randomized controlled trial | 276 | Acute care hospital | Nurses, GP, OT/PT, SLP, dietician, SW, pain team, CNS | 76 | 61 | NR | NR | NR | NR |
Richardson, 1986 [54] US | Mixed/multiple methods | NR | Rural hospital | OT, PT, SLP, Hearing services, dental, SW, discharge planners | 75+ | NR: mostly women | NR | NR | NR | ~ 50% lived alone |
Steiner, 2001 [55] Europe | Randomized controlled trial | 240 | Acute care hospital | Nurses, PT, doctors can be called in an emergency | 72.2 | 49 | NR | Cognitively impaired at randomisation intervention: 39/114; control 32/119 | BI: IG 63.5 (23.5); CG 60.3 (22.8) | 62.4% alone |
Tappen, 2001 [56] US | Quasi-experimental repeated measures | 242 | SNF | Nursing, other professions NR | 76.8 (SD 11.18) | 74 | 1.92 | Excluded if MMSE < 21 | FIM: 84.34 (21.76)% Katz index: 6.32 (2.89) Lawton & Brody scale: 10.73 (4.80) | NR, but eligible if adequate cognition |
Trappes-Lomax, 2006 [57] Europe | Non-randomized controlled trial | 228 | LTCH/NH | Rehabilitation assistants, OT, PT, patient’s own GP provides clinical care | 83.1 (7.1) | 68 | NR | NR | BI: IG 74.6 (21.7) CG 75.1 (20.9) | 67.0% alone |