To synthesise evidence of the effectiveness of community based complex interventions, grouped according to their intervention components, to sustain independence for older people. The review included 129 studies. Nineteen intervention components, including "multifactorial action from individualised care planning", were identified in 63 combinations. For living at home, compared with no intervention/placebo, evidence favoured multifactorial action from individualised care planning including medication review and regular follow-ups; multifactorial action from individualised care planning including medication review without regular follow-ups; combined cognitive training, medication review, nutritional support, and exercise; and combined activities of daily living training, nutritional support, and exercise (1.79, 0.67 to 4.76; low certainty). Risk screening or the addition of education and self-management strategies to multifactorial action from individualised care planning and routine review with medication review may reduce odds of living at home. For instrumental activities of daily living, evidence favoured multifactorial action from individualised care planning and routine review with medication review. Two interventions may reduce instrumental activities of daily living: combined activities of daily living training, aids, and exercise; and combined activities of daily living training, aids, education, exercise, and multifactorial action from individualised care planning and routine review with medication review and self-management strategies.
Reproduced with permission from the BMJ Publishing Group.

Full text (sometimes free) may be available at these link(s):      help

• PubMed Central
• DOI
• PubMed
• PDF locator
• publisher