SynthesisJournal of the Royal Society of Medicine2024
The effects of community interventions on unplanned healthcare use in patients with multimorbidity: a systematic review.
Synthesis in Journal of the Royal Society of Medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Advance care planning for patients with advanced multiple long-term conditions: a qualitative thematic analysis of health and social care professionals' perspectives.BMC palliative care · 2026Article
- Community-based management strategies for adults with multimorbidity: a systematic review of clinical and patient-centred outcomes.BMJ public health · 2026Article
- Challenges and strategies in the care of older adults across the continuum of intensive and post-intensive care medicine.Intensive care medicine · 2026Review
- Factors influencing emergency department utilisation using Andersen's behavioural model: a cross-sectional study in a public hospital in Malaysia.Frontiers in public health · 2026Article
- Observational
- Contributions of Specialized Nurses to Medication Management for Older People in Home Care: A Mixed-Method Systematic Review.Risk management and healthcare policy · 2025Review
- A long way from Frome: improving connections between patients, local services and communities to reduce emergency admissions.BMC primary care · 2024Article
- Non-emergency department (ED) interventions to reduce ED utilization: a scoping review.BMC emergency medicine · 2024Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo summarise the impact of community-based interventions for multimorbid patients on unplanned healthcare use. The prevalence of multimorbidity (co-existence of multiple chronic conditions) is rapidly increasing and affects one-third of the global population. Patients with multimorbidity have complex healthcare needs and greater unplanned healthcare usage. Community-based interventions allow for continued care of patients outside hospitals, but few studies have explored the effects of these interventions on unplanned healthcare usage.
designA systematic review was conducted. MEDLINE, EMBASE, PsychINFO and Cochrane Library online databases were searched. Studies were screened and underwent risk of bias assessment. Data were synthesised using narrative synthesis.
settingCommunity-based interventions.
participantsPatients with multimorbidity.
main outcome measuresUnplanned healthcare usage.
resultsThirteen studies, including a total of 6148 participants, were included. All included studies came from high-income settings and had elderly populations. All studies measured emergency department attendances as their primary outcome. Risk of bias was generally low. Most community interventions were multifaceted with emphasis on education, self-monitoring of symptoms and regular follow-ups. Four studies looked at improved care coordination, advance care planning and palliative care. All 13 studies found a decrease in emergency department visits post-intervention with risk reduction ranging from 0 (95% confidencec interval [CI]: -0.37 to 0.37) to 0.735 (95% CI: 0.688-0.785).
conclusionsCommunity-based interventions have potential to reduce emergency department visits in patients with multimorbidity. Identification of specific successful components of interventions was challenging given the overlaps between interventions. Policymakers should recognise the importance of community interventions and aim to integrate aspects of these into existing healthcare structures. Future research should investigate the impact of such interventions with broader participant characteristics.
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