Outcome on Integrated Community Care Interventions for Frail Elderly Through Literature Review

Monday, 30 October 2017

Junko Imaiso, PhD
School of Nursing, University of Shizuoka, Shizuoka-shi, Japan

Background: In Japan, it is suggested that integrated community care systems should be constructed in each community by 2025. It is natural that health conditions deteriorate with aging. Aging populations are global concern in near future. It is important that the significant integrated community care system for the frail elderlys and their families centered should be constructed considering the evaluation about the effect.

Purpose: The aim of this study is to summarize the outcome of effective integrated community care outcomes for frail elderly based on the literature review.

Method: A systematic review is performed in the Cochrane Library, PubMed with a search until November 2016. The search strategy employed the following terms: integrated community care, primary care, community, frail elderly, and effectiveness.

Results: Overall, 106 references were identified of which eight studies met the inclusion criteria. Seven of the identified studies were conducted in the Netherlands and another was in Canada. The research paper in 2016 was five and in 2013 was one, in 2008 was one, in 2004 was one. About research design in eight studies, RCT (Randomized Controlled Study) was four, non-randomized was one and quasi-experimental was three. All outcome indicators were summarized in categories: quality of life, health, functional abilities and social support. Health included two elements: physical-related health, mental-related health. Functional abilities included two elements: physical function and social function. Social support meant the use of the social supports such as hospital, primary care consultation or neighborhood. The functional abilities of the frail elderly reached statistical the significant effect in the intervention group in two researches. However, the quality of life, health, social support did not reach statistical the significant difference. The outcome focused on not only frail elderly but also their caregivers was one research, and the caregivers’ burden reached statistical the significant effective in the intervention group. And, the research considering the character of the community, a semi-urban community, was one, but the outcome was not cleared.

Discussions: It seems that the effectiveness of it is not clear on the research on the global sight. The topic is new. In fact, about 62% in the identified research papers was in 2016. When we consider the patients and their families centered effective care based on the community, we think that the quality of life for the frail elderly and their families in the residential community is more important than the other indicators. In this systematic review, the used measurements related with quality of life were different by the research. The important elements in the quality of life for the frail elderly and their caregivers in their residential communities should be considered. Therefore, it is important that the research about the effective of the integrated community care for the frail and their families considering the residential community should be globally piled.

Conclusions: Although it is suggested that the integrated community care system should be constructed, the effectiveness is not enough through conducting the research. More research is needed to gain insight in the process of promoting the quality of life of the frail elderly and their caregivers considering the character of their residential community.