Key result
Protocol details upcoming review of interventions targeting adverse outcomes in older adults after ED discharge.
Why the study?
Older adults are vulnerable to adverse outcomes following ED discharge, and existing systematic reviews of heterogeneous interventions have used varying methodologies.
Do Emergency Department interventions reduce adverse outcomes in older adults following ED discharge?
Systematic Review
Do Emergency Department interventions reduce adverse outcomes in older adults following ED discharge?
This is a protocol for an overview of systematic reviews evaluating interventions to reduce adverse outcomes in older adults discharged from the ED.
No synthesized evidence yet guides ED interventions for older adults post-discharge; protocol leaves open their effectiveness on adverse outcomes.
<ns4:p> <ns4:bold>Background:</ns4:bold> Older adults are frequent users of Emergency departments (ED) and this trend will continue due to population ageing and the associated increase in healthcare needs. Older adults are vulnerable to adverse outcomes following ED discharge. A number of heterogeneous interventions have been developed and implemented to improve clinical outcomes among this cohort. A growing number of systematic reviews have synthesised evidence regarding ED interventions using varying methodologies. This overview aims to synthesise the totality of evidence in order to evaluate the effectiveness of interventions to reduce adverse outcomes in older adults discharged from the ED. </ns4:p> <ns4:p> <ns4:bold>Methods:</ns4:bold> To identify relevant reviews, the following databases will be searched: Cochrane Database of Systematic reviews, Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, Databases of Abstracts of Reviews of Effects, PubMed, MEDLINE, Epistemonikos, Ageline, Embase, PEDro, Scopus, CINAHL and the PROSPERO register. The search for grey literature will include Open Grey and Grey Literature Reports. Systematic reviews of randomised controlled trials will be analysed to assess the effect of ED interventions on clinical and process outcomes in older adults. Methodological quality of the reviews will be assessed using the Assessment of Multiple Systematic Reviews 2 tool. The review will be reported in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Summary of findings will include a hierarchical rank of interventions based on estimates of effects and the quality of evidence. </ns4:p> <ns4:p> <ns4:bold>Discussion:</ns4:bold> This overview is required given the number of systematic reviews published regarding the effectiveness of various ED interventions for older adults at risk of adverse outcomes following discharge from the ED. There is a need to examine the totality of evidence using rigorous analytic techniques to inform best care and potentially develop a hierarchy of treatment options. </ns4:p> <ns4:p> <ns4:bold>PROSPERO registration</ns4:bold> : <ns4:ext-link xmlns:ns5="http://www.w3.org/1999/xlink" ext-link-type="uri" ns5:href="https://www.crd.york.ac.uk/prospero/display_record.php?
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Conneely et al. (2021) conducted a systematic review in Older adults discharged from the Emergency Department. Emergency department interventions was evaluated on Clinical and process outcomes / adverse outcomes. This is a protocol for an overview of systematic reviews aiming to evaluate the effectiveness of interventions to reduce adverse outcomes in older adults discharged from the emergency department.
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