Older adults and families/caregivers' experiences of access and use of emergency medical services (EMS): a study protocol for a qualitative evidence synthesis

Older adults account for one of the largest users of Emergency Medical Services (EMS) and require specialised care and tailored interventions during this time. The experiences of older adults and those important to them is crucial to ensure an age-friendly EMS. This review aims to systematically identify and synthesise qualitative literature regarding older adults and their families and informal caregivers’ experiences of access and use of EMS. The review will employ a seven-step meta-ethnographic approach (Noblit & Hare, 1988) of qualitative evidence synthesis. Five databases will be searched: Medline, CINAHL, PsycInfo, Academic Search Complete and Embase. The search strategy will be supplemented with citation-chasing. Study selection will be informed by a two-step purposive sampling technique that will be used to determine the richness of studies alongside the relevance of their scope and objectives. The CASP-checklist will be used to critically assess the quality of the included studies. A Public Patient Involvement panel of older adults and family carers has shaped the conceptualisation of the research question and will engage in the synthesis and dissemination of findings. The confidence of findings will further be assessed using the GRADE-CERQual framework. The findings of this meta-ethnography will generate new conceptual understanding of how older adults and those important to them experience pre-hospital emergency care offering an in-depth richness and understanding and informing the design and implementation of an age-attuned EMS.