Systematic Review of Interdisciplinary Interventions in Nursing Homes

Arif Nazir, Kathleen Unroe, Monica Tegeler, Babar Khan, Jose Azar, Malaz Boustani

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background: The role of interdisciplinary interventions in the nursing home (NH) setting remains unclear. We conducted a systematic evidence review to study the benefits of interdisciplinary interventions on outcomes of NH residents. We also examined the interdisciplinary features of successful trials, including those that used formal teams. Data Sources: Medline was searched from January 1990 to August 2011. Search terms included residential facilities, long term care, clinical trial, epidemiologic studies, epidemiologic research design, comparative study, evaluation studies, meta-analysis and guideline. Study Selection: We included randomized controlled trials (RCTs) evaluating the efficacy of interdisciplinary interventions conducted in the NH setting. Measurements: We used the Cochrane Collaboration tools to appraise each RCT, and an RCT was considered positive if its selected intervention had a significant positive effect on the primary outcome regardless of its effect on any secondary outcome. We also extracted data from each trial regarding the participating disciplines; for trials that used teams, we studied the reporting of various team elements, including leadership, communication, coordination, and conflict resolution. Results: We identified 27 RCTs: 7 had no statistically significant effect on the targeted primary outcome, 2 had a statistically negative effect, and 18 demonstrated a statistically positive effect. Participation of residents' own primary physicians (all 6 trials were positive) and/or a pharmacist (all 4 trials were positive) in the intervention were common elements of successful trials. For interventions that used formal team meetings, presence of communication and coordination among team members were the most commonly observed elements. Conclusion: Overall interdisciplinary interventions had a positive impact on resident outcomes in the NH setting. Participation of the residents' primary physician and/or a pharmacist in the intervention, as well as team communication and coordination, were consistent features of successful interventions.

Original languageEnglish
Pages (from-to)471-478
Number of pages8
JournalJournal of the American Medical Directors Association
Volume14
Issue number7
DOIs
StatePublished - Jul 2013

Fingerprint

Nursing Homes
Randomized Controlled Trials
Communication
Epidemiologic Research Design
Pharmacists
Interdisciplinary Studies
Residential Facilities
Physicians
Information Storage and Retrieval
Negotiating
Long-Term Care
Meta-Analysis
Epidemiologic Studies
Clinical Trials
Guidelines

Keywords

  • Interdisciplinary care
  • Nursing homes
  • Randomized trials
  • Teamwork

ASJC Scopus subject areas

  • Medicine(all)
  • Nursing(all)
  • Health Policy

Cite this

Systematic Review of Interdisciplinary Interventions in Nursing Homes. / Nazir, Arif; Unroe, Kathleen; Tegeler, Monica; Khan, Babar; Azar, Jose; Boustani, Malaz.

In: Journal of the American Medical Directors Association, Vol. 14, No. 7, 07.2013, p. 471-478.

Research output: Contribution to journalArticle

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