There is limited and inconsistent evidence on the effectiveness of preventive home visits to the elderlyEffects of preventive home visits to elderly people living in the community: systematic review.

Campbell, Professor A. John
van Haastregt, JCM
Diederiks, JPM
van Rossum, E
de Witte, LP
Crebolder, HFJM

University of Otago Medical School, New Zealand

Abstracted from:van Haastregt JCM, Diederiks JPM, van Rossum E, de Witte LP, Crebolder HFJM. Effects of preventive home visits to elderly people living in the community: systematic review. BMJ 2000;320:754-758van HaastregtJCMDiederiksJPMvan RossumEde WitteLPCrebolderHFJMEffects of preventive home visits to elderly people living in the community: systematic review.BMJ2000320754-758 .

Evidence-based Healthcare 4(4):p 77, December 2000.

BACKGROUND

There is much interest in measures that aim to maintain the health of elderly people in the community. One such intervention is preventive home visits.

OBJECTIVE

To examine the effects of preventive home visits to elderly people.

METHOD

Systematic review of randomised controlled trials.

LITERATURE REVIEW

MEDLINE 1966-May 1999; EMBASE 1989-March 2000; Cochrane Controlled Trials Register; hand-searching of references.

INCLUSION AND EXCLUSION CRITERIA

Trials assessing home visits to people aged 65 and above. Outcomes were physical and psycho-social function scores; rate of falls; admission rates; mortality.

DATA EXTRACTION AND SYNTHESIS

Trials were scored according to 19 quality criteria by two independent reviewers who were blinded to study authorship. Inclusion and exclusion criteria of trials were extracted, as were follow-up time and details of interventions.

MAIN RESULTS

Fifteen trials were identified. Heterogeneity among trials was too great to allow meta-analysis. Eight trials reported at least one result favouring home visits over control intervention. Five trials reported no significant differences between groups for any measured outcome. None of the trials reported negative effects. TABLE

Table. No caption available.
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AUTHORS' CONCLUSIONS

No clear evidence of benefit was found for preventive home intervention. The effects were modest, inconsistent and must be weighed against the costs of home visits. Some of the trials were probably underpowered to detect a practically important difference. To improve the effectiveness of visits, a better understanding of the relation between characteristics of the home visits and favourable outcomes is needed. However, the information was not available from most of these trials to make this assessment.