Defining the Components of a Nurse Practitioner-Led Home Visit Intervention for Frail Patients: An International Delphi Consensus Study

PURPOSE: Aging in place has become a central objective of health and social policies across the world, yet frailty and multimorbidity undermine individuals' capacity to remain safely at home. The aim was to identify the components of a home visit intervention led by nurse practitioners for frail populations. DESIGN: A consensus study using a two-round Delphi method. METHODS: A two-round Delphi study was conducted in 2024 with 15 experts from four French-speaking countries (Quebec-Canada, Switzerland, Belgium, and France). Experts included healthcare professionals with expertise in home care, rural healthcare services, or access to care for frail populations. The questionnaires were based on documented needs of frail patients and their caregivers. RESULTS: Experts identified the target population as older adults needing home care, people with physical or cognitive impairments, those requiring end-of-life care, and individuals experiencing difficulties remaining at home. Eligibility criteria included frailty, multiple chronic conditions, mobility issues, social isolation, and low socio-economic status. The nurse practitioner's role should include clinical assessment, treatment adjustments, care coordination, therapeutic education, support for patients and families, and promotion of self-care. Nurse practitioners may serve as a reference for healthcare professionals. Home visits should be initiated by healthcare providers, patients, or family members, with visit frequency and duration adapted to individual needs. CONCLUSIONS: This study identified components of a nurse practitioner-led home visit intervention for frail individuals that achieved expert consensus, while highlighting areas where consensus was not reached. CLINICAL RELEVANCE: These findings will inform the development and evaluation of such an intervention.