Article Text
Abstract
Objectives Nursing home (NH) residents experience a high burden of chronic disease. Chronic disease management (CDM) can be a challenge, as the context of care provision and the way care is provided impact care delivery. This scoping review aimed to identify types of chronic diseases studied in intervention studies in NHs, influential contextual factors addressed by interventions and future CDM research considerations.
Design The scoping review followed guidelines by Arksey and O’Malley (2005) and Levac, Colquhoun and O’Brien (2010). Six reviewers screened citations for inclusion. Data extraction was performed by one reviewer and verified by a second reviewer.
Data sources We searched four databases: CINAHL, EMBASE, PubMed and Scopus, in March 2018.
Eligibility criteria Studies were included if (1) aim of intervention was to improve CDM, (2) intervention incorporated the chronic care model (CCM), (3) included NH residents, (4) analysed the efficacy of the intervention and (5) sample included adults over age 65 years. Studies were limited to English or French language and to those published after 1996, when the CCM was first conceptualised.
Data extraction and synthesis Extracted information included the type of chronic disease, the type and number of CCM model components used in the intervention, the method of delivery of the intervention, and outcomes.
Results On completion of the review of 11 917 citations, 13 studies were included. Most interventions targeted residents living with dementia. There was significant heterogeneity noted among designs, outcomes, and type and complexity of intervention components. There was little evaluation of the sustainability of interventions, including feasibility.
Conclusions Research was heavily focused on management of dementia. The most commonly included CCM components were multidisciplinary care, evidence-based care, coordinated care and clinical information systems. Future research should include subjective and objective outcomes, which are meaningful for NH residents, for common chronic diseases.
- chronic disease management
- nursing home
- scoping review
- intervention studies
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Footnotes
Contributors Study concept and design: VB, GH and APC. Acquisition of data: MD, LEC, KJ, LST, MH, VB and GH. Analysis and interpretation of data: VB, GH, APC, LEC, MD, LST, MH and KJ. Drafting of the manuscript: VB and LEC. Critical revision of the manuscript for important intellectual content: VB, GH, APC, LEC, LST, MH and KJ.
Funding This work was supported by the Ministry of Health and Long-Term Care’s 2017-2020 Health System Research Fund (HSRF; Grant #255). VB receives salary support from the Natural Science and Engineering Research Industrial Council of Canada (NSERC) through the Industrial Research Chair for Colleges Program, supported by Schlegel Villages and the Schlegel-UW Research Institute for Aging. GH receives salary support from the University of Waterloo and Schlegel-UW Research Institute for Aging. APC receives salary support from McMaster University and the Schlegel-UW Research Institute for Aging.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article or uploaded as supplementary information.