[Integrated care management for older people with chronic diseases in domesticity: evidence from Cochrane reviews].

Autor: Göhner A; Zentrum für Geriatrie und Gerontologie Freiburg, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Lehener Straße 88, 79106, Freiburg, Deutschland. anne.goehner@uniklinik-freiburg.de.; Public Health & Health Education, Pädagogische Hochschule Freiburg, Freiburg, Deutschland. anne.goehner@uniklinik-freiburg.de., Bitzer EM; Public Health & Health Education, Pädagogische Hochschule Freiburg, Freiburg, Deutschland., Dreher E; Zentrum für Geriatrie und Gerontologie Freiburg, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Lehener Straße 88, 79106, Freiburg, Deutschland., Farin-Glattacker E; Sektion Versorgungsforschung und Rehabilitationsforschung, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland., Heimbach B; Zentrum für Geriatrie und Gerontologie Freiburg, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Lehener Straße 88, 79106, Freiburg, Deutschland., Kohler K; Zentrum für Geriatrie und Gerontologie Freiburg, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Lehener Straße 88, 79106, Freiburg, Deutschland., Maun A; Institut für Allgemeinmedizin, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland., Metzner G; Sektion Versorgungsforschung und Rehabilitationsforschung, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland., Voigt-Radloff S; Zentrum für Geriatrie und Gerontologie Freiburg, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Lehener Straße 88, 79106, Freiburg, Deutschland.; Institut für Evidenz in der Medizin (für Cochrane Deutschland Stiftung), Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland.
Jazyk: němčina
Zdroj: Zeitschrift fur Gerontologie und Geriatrie [Z Gerontol Geriatr] 2021 Feb; Vol. 54 (1), pp. 54-60. Date of Electronic Publication: 2020 Oct 12.
DOI: 10.1007/s00391-020-01796-1
Abstrakt: Background: The number of multiple chronically ill older people is increasing and multimorbidity is associated with high utilization of health services. Integrated care management is increasingly used to address this problem; however, there is a substantial lack of reliable data on its effectiveness in this target group.
Objective: To assess the effectiveness of components of integrated care management in adults of all ages and to estimate the transferability to older, multimorbid people in Germany.
Methods: A systematic search was carried out in the Cochrane Library for Cochrane reviews (CR) on (a) the 13 most frequent health problems in old age, which (b) evaluated components of integrated care management in (c) adults of all ages. Experts assessed the transferability of the included CR to multiple chronically ill older people in Germany.
Results: Out of 1412 hits 126 CR were included. Regarding independence and functional health outcomes, 25 CR showed clinically relevant results with at least a moderate level of evidence. The following intervention components were estimated to be transferable and could be adapted to be part of an effective integrated care management for multimorbid chronically ill older people, specified by indications and taking identified barriers into account: (1) physical activation, (2) multidisciplinary interventions (3) interventions that enhance self-management, (4) cognitive therapy modalities, (5) telemedical interventions and (6) disease management programs.
Conclusion: The effectiveness of the identified components in frail older patients should be assessed in care-related and patient-related randomized controlled studies.
Databáze: MEDLINE
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