Interventions to Reduce Hospitalisation of Nursing Home Residents: A Scoping Review of Randomised Controlled Trials

Abstract Purpose of Review There are increasing numbers of nursing home residents across the world, at greater risk of hospitalisations. These admissions are potentially avoidable and have an economic and societal cost, in health and quality of life, to residents and the wider healthcare system. Guided by the Arksey and O’Malley framework, we conducted a scoping review of randomised controlled trials (RCTs) on interventions to reduce hospitalisations in nursing home residents, identifying the interventions studied, methods used, and outcomes reported to highlight gaps for future research. We undertook the scoping review following the suggestions of Arksey and O’Malley, using a comprehensive search strategy in Medline and EMBASE. Studies eligible for inclusion were randomised controlled trials published in English, with residents of institutionalised care facilities ≥ 65 years, considering any intervention that aimed to reduce hospitalisations and examined general hospitalisation as an outcome. Studies were excluded if the intervention focused on preventing specific chronic conditions. Recent Findings 43 trials were included in the scoping review, covering a variety of themes, including advanced care planning, multidisciplinary approaches and medication reviews. Summary A variety of interventions to reduce hospitalisation have been trialed, but little randomised trial evidence is available for interventions extending beyond procedural aspects within the nursing home, particularly health promotion interventions such as physical activity. This review calls for further systematic reviews on the themes of intervention, and additional research in those themes where limited research was identified.