A scoping review of community holistic interventions for older people with multimorbidity

Smith, Timothy orcid iconORCID: 0000-0002-1460-7394, Patel, Tahera, Akpan, Asangaedem, Clegg, Andrew orcid iconORCID: 0000-0001-8938-7819, Watkins, Caroline Leigh orcid iconORCID: 0000-0002-9403-3772, Lightbody, Catherine Elizabeth orcid iconORCID: 0000-0001-5016-3471 and Chauhan, Umesh orcid iconORCID: 0000-0002-0747-591X (2020) A scoping review of community holistic interventions for older people with multimorbidity. The British journal of general practice : the journal of the Royal College of General Practitioners, 70 (1). ISSN 0960-1643

Full text not available from this repository.

Official URL: https://doi.org/10.3399/bjgp20X711509


In many areas, new regional community-based services have been established to provide holistic care to patients with high physical, mental and social needs. Older people represent a group with multimorbidity and high healthcare needs that may benefit from holistic care, although uncertainty remains whether such an approach is effective. To review evidence for community holistic interventions in older people with multimorbidity. The authors screened studies referenced by an earlier Cochrane Review and Academy of Medical Sciences report, both of which looked at interventions and populations more broadly, and their own searches of Medline, EMBASE, trial registration databases and hand-searching of journals since 2015. The authors included controlled community-based studies of holistic interventions with data for people aged at least 60 years. Studies found (five published, two ongoing) were heterogeneous. The only significant improvement relating to physical or mental outcomes occurred in self-rated health scores, seen in two studies. One consisting entirely of diabetics showed developing a self-management plan improved self-rated health ( = 0.023), and Mental Component Summary ( = 0.03). The other used a multidisciplinary-team-guided personal care plan and found self-rated overall health improved ( = 0.02). Three studies looked at service usage, only one seeing a benefit, and only in the second year. Community-based holistic interventions for people with multimorbidity tended to focus on disease management or medication modification, and resulted in few significant benefits, almost entirely in self-rated health measures. Research into interventions focused on those with the highest needs, for example, multimorbidity with frailty; high number of comorbidities may be more likely to demonstrate meaningful benefits. [Abstract copyright: © British Journal of General Practice 2020.]

Repository Staff Only: item control page