Evaluating the Impact of Nurse-led Geriatric Homecare Interventions: A Systematic Review of Randomized Controlled Trials

Abstract

Nurse-led interventions have gained prominence as a promising approach for geriatric care, yet the existing evidence base remains limited. This systematic review aimed to evaluate the impact of nurse-led home care interventions on health outcomes. Adhering to the PRISMA guidelines, we conducted a comprehensive search of PubMed, ScienceDirect, Scopus, ProQuest, and Embase databases from their inception until April 2024. A narrative synthesis was used. Following the screening of 901 studies derived across five electronic databases, nine trials were analyzed in this review. The interventions showed mixed results on quality of life, with significant improvements in some studies but not others. Physical health and performance generally improved, with fewer falls and better functional status in the intervention groups. Mental health outcomes were also mixed. Caregiver burden did not significantly change overall, but some aspects, such as isolation, improved. Hospitalization rates did not significantly differ between groups in most studies, but emergency department visits were lower in the intervention groups. Mortality rates were also similar between groups, but more patients in the intervention groups died at home. Despite the diversity in approaches, nurses played an active and comprehensive role in all programs. These findings highlight the adaptability and flexibility of nurse-led interventions. Further research is needed to refine these interventions, identify their most effective components, and understand how they can be tailored to meet the unique needs of older adults and their caregivers.