| Titre : | Home visits to prevent nursing home admission and functional decline in elderly people : Systematic review and meta-regression analysis. (2002) |
| Auteurs : | Andreas-E Stuck ; John-C Beck ; Matthias EGGER ; Andreas HAMMER ; Christoph-E MINDER ; Department of Geriatrics and Rehabilitation. Spital Bern Ziegler. Bern. CHE |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 287, n° 8, 2002) |
| Pagination : | 1022-1028 |
| Langues: | Anglais |
| Mots-clés : | Personne âgée ; Homme ; Consultation ; Prévention santé ; Entrée ; Programme santé ; Maison accueil personne âgée ; Visite |
| Résumé : | [BDSP. Notice produite par INIST-CNRS R0x9d7Y4. Diffusion soumise à autorisation]. Context The effects of home visitation programs to prevent functional decline in elderly persons have been inconsistent, and the value of these programs is controversial. Objective To evaluate the effect of preventive home visits on functional status, nursing home admission, and mortality. Data Sources Studies published in English, French, German, Italian, or Spanish reporting randomized trials of the effects of preventive in-home visits in older people (mean age>70 years) living in the community were identified through searches of MEDLINE, PSYCHINFO, and EMBASE (January 1985-November 2001). We also searched the Cochrane Controlled Trials Register, checked reference lists of earlier reviews and book chapters, searched conference proceedings and specialty journals, and contacted experts. Study Selection We screened 1349 abstracts and excluded those that did not test in-home interventions or in which the mean age of the study population was younger than 70 years. After further exclusions, 17 articles describing 18 trials were analyzed. Data Extraction Two reviewers independently screened abstracts. Discrepancies were resolved by consensus with a third reviewer. For each included trial, we extracted data on the study population and the characteristics of the intervention. Two of us extracted information on 3 end points : nursing home admissions, mortality, and functional status. One of us assessed trial quality, including an examination of the method of randomization, blinding of caregivers and research staff ascertaining outcomes, and proportion of patients included in analyses of the 3 end points. Data Synthesis The 18 trials included 13447 individuals aged 65 years and older. The effect on nursing home admissions depended on the number of visits performed during follow-up. The pooled relative risk (RR) was 0.66 (95% confidence interval [CI], 0.48-0. (...) |
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