Profession-led vs collaborative workforce models in dental, vision, and hearing care for older adults in community care: A mixed-methods systematic review

BACKGROUND: Dental, vision, and hearing impairments are among the most prevalent long-term conditions affecting older adults, contributing to late-life disability and reducing quality of life. Early detection and prevention may reduce avoidable emergency hospitalizations and health system costs while enhancing well-being. Despite this, integrated service delivery across these sensory and oral health domains remains limited, especially in community care settings. AIM: This systematic review aimed to synthesize evidence on integrated workforce models involving dental, vision, and hearing professionals within community care settings for older adults. METHODS: A mixed-method systematic review was conducted using a comprehensive three-step search strategy across MEDLINE, CINAHL, Web of Science, Embase, and Scopus spanning January 2010 to December 2024, and updated in October 2025. In all, 798 articles were identified, with 14 meeting inclusion criteria for convergent integrated synthesis. Included studies involved adults aged 60+ or with samples containing at least 50% older adults, examining community-based models where dental, vision, or hearing personnel collaborated with at least one other health or welfare provider. Critical appraisal and data synthesis followed the Joanna Briggs Institute methodology. RESULTS: Of the 14 studies (5 qualitative, 6 mixed methods, 3 quantitative), 9 focused on dental, 3 on vision, and 2 on hearing workforce models. Studies were primarily from the United States (n=8), Australia (n=2), the Netherlands (n=2), Germany (n=1), and Norway (n=1). Two workforce model types emerged inductively: profession-led models (n=10), characterized by leadership and care coordination, and led by a dental, vision or hearing expert, and collaborative-led models (n=4), featuring shared leadership and an extended skill mix. Profession-led models emphasized clinical interventions; collaborative-led models prioritized health promotion and prevention. Reported outcomes primarily related to service delivery, workforce processes, and patient experiences, including patient satisfaction. Evidence of clinical effectiveness outcomes was limited, and studies varied substantially in design, context and outcome measures. CONCLUSION: Integrated workforce models in dental, vision, and hearing for older adults in community care show promise in improving care delivery processes and patient-reported outcomes. However, the current evidence base is limited and heterogenous, with few robust evaluations of clinical effectiveness. As such, these models need to undergo further rigorous research to assess their effectiveness, scalability, and context-specific implementation.