Evidence mapPaperPMID 41639636Full record

SynthesisBMC geriatrics2026

The effectiveness of alternatives to residential care for older people with on-going health and social care needs: a systematic review.

Elaine Moody, Heather McDougall, Elliot Paus Jenssen, Caitlin McArthur, Rebecca Affoo, Lori E Weeks, Marilyn Macdonald, Arezoo Mojbafan, Erin Langman

Abstract readSystematic Review
In one paragraph

Synthesis in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Elaine MoodySchool of Nursing, Dalhousie University, Halifax, NS, Canada. elaine.moody@dal.ca.
Heather McDougallSchool of Nursing, Dalhousie University, Halifax, NS, Canada.
Elliot Paus JenssenStrategy for Patient-Oriented Research (SPOR) Evidence Alliance Citizen Lead, Saskatoon, SK, Canada.
Caitlin McArthurSchool of Physiotherapy, Dalhousie University, Halifax, NS, Canada.
Rebecca AffooSchool of Communication Sciences and Disorders, Dalhousie University, Halifax, NS, Canada.
Lori E WeeksJBI Aligning Health and Evidence for Transformative Change, Dalhousie University, Halifax, NS, Canada.
Marilyn MacdonaldSchool of Nursing, Dalhousie University, Halifax, NS, Canada.
Arezoo MojbafanFaculty of Health, Dalhousie University, Halifax, NS, Canada.
Erin LangmanUniversity Library, University of Saskatchewan, Saskatoon, SK, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOlder adults are more likely than younger people to have multiple chronic health conditions and increased health and/or social needs. As older people generally prefer living at home in the community as they age and residential care can be expensive, there is a need for effective alternatives to residential care in the community. The objective of this review was to synthesize evidence about programs aimed at enabling older people with ongoing health and social care needs to remain in the community.

methodsThis review followed the JBI methodology for systematic reviews of effectiveness. Included studies reported on complex, multifactorial interventions that were based in the community and included more than one type of service. Six databases and gray literature were searched for published and unpublished research. Titles and abstracts, and full-text selections were screened by two or more reviewers and assessed for methodological quality using JBI critical appraisal tools. Results related to quality of life and healthcare outcomes were extracted.

resultsFifty-five full text articles, reporting on 51 unique complex interventions, were included in the review. Studies were predominantly randomized controlled trials (n=24) and quasi-experimental studies (n=23), with five cohort and three case series studies included. The overall quality of the included studies was moderate. Key characteristics of the interventions included case management, care planning, a comprehensive assessment, and in-home visits. Comparative meta-analyses were completed for five of the outcomes (hospital admission, emergency department visits, long-term care use, primary care use and quality of life). The results showed effects in the direction of interventions for the number of hospital admissions and LTC use, however, none of the meta-analyses were statistically significant.

conclusionsThere is little agreement about the effectiveness of complex interventions on quality of life and health system outcomes. Jurisdictional differences may make the integration of literature reporting on such interventions particularly difficult. There is an ongoing need to understand what helps older people with complex needs live well in the community and what level of health system engagement is optimal. SYSTEMATIC REVIEW REGISTRATION: PROSPERO reference number CRD42022324061.

Indexed as

Health Services Needs and DemandResidential FacilitiesAgedAged, 80 and overAging in PlaceHumansQuality of LifeRandomized Controlled Trials as Topic(3–10): multifactorial interventionCommunityFrailtyMultimorbidityOlder adults

Identifiers

PMID41639636
PMCPMC12958567

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.