Project 3: Rapid evidence syntheses on key topics
Full title: Older people and frailty – rapid evidence syntheses on key topics
A series of reviews are proposed in priority order, agreed with DHSC, with the aim of creating pragmatic syntheses that are tailored to the nature of the evidence and timescale to suit the needs of policymakers.
This is flexible work that is designed to respond to the changing needs of the DHSC and make the best use of employed researcher resources.
- Synthesise available research evidence on a small number of key questions in the health and care of older adults.
- Produce pragmatic summaries of the evidence to inform policy, practice and the future work programme of the PRU.
Digital inclusion of older adults and implications for health and social care
What are the barriers and facilitators to using digital technologies, the opportunities for intervention, and the effectiveness and cost-effectiveness of existing initiatives?
Digital technologies, if available to all according to need, can play a vital role in achieving equitable health and social care.
Unfortunately, some groups within the population, particularly older adults, are unable to access or use health-related technologies.
This rapid evidence synthesis will inform policy, best practice and identify gaps in our knowledge, helping to correct these health inequalities.
We aim to answer the following questions:
- What are the effective interventions to increase access to/utilisation of (health and social care-related) digital technologies by older adults?
- What are the barriers and facilitators to use of (health and social care-related) digital technologies by older adults?
- What are the characteristics of older adults who do not have access to/use digital technologies?
This review shall support commissioners in primary health and social care in their commitment to deliver information and services digitally wherever appropriate, with a focus not to widen the health inequality gap within the older population or between generations.
Social connections for health and wellbeing
What are the effective interventions to promote and sustain social connections, and what resources are needed to implement effective interventions?
Social isolation and loneliness influence our quality of life, wellbeing and utilisation of health and social care services, and have an adverse impact on morbidity and mortality.
Following the UK government’s publication of the world’s first loneliness strategy, more intervention evidence gathering is required to guide commissioning decisions and shape future research priorities.
This review focuses on older people identified as being, or at risk of being, socially isolated and/or lonely, and includes interventions aimed at reducing or preventing loneliness and/or social isolation.
We aim to answer the following questions:
- What are effective and cost-effective interventions to promote and sustain social connections for older people?
- What resources are required to implement effective and cost-effective interventions?
The proposed topic has been chosen to support a key current policy topic. The main audience will be the Department of Health and Social Care, the Department of Digital, Culture, Media and Sport and other government departments, and commissioners and social care in particular.
What interventions are (cost) effective in preventing, reversing or slowing progression of frailty?
Frailty is a distinctive, age-related health state, in which multiple body systems gradually lose their in-built reserves, which increases an individual’s risk of poor health outcomes including falls, incident disability, hospitalisation and mortality.
With an ageing population, it is more important than ever to understand the evidence base around frailty-related interventions, as our understanding of how best to prevent, slow or reverse the progression of frailty has important implications for public health and resource use.
We aim to identify the interventions that are (cost) effective in preventing, reversing or slowing progression of frailty.
This is a key priority for policy and strategy within DHSC and NHS England.
End of life
What are the best approaches to prognostication for older people with non-cancer frailty?
While end of life services for cancer are well developed, the majority of older adults live and die with a combination of frailty, disability and multiple chronic conditions.
This study shall assess the growing literature on early intervention to support dying well, and look to show when and how to identify frail older adults with end of life and palliative care needs, and discuss why this might or might not be advantageous.
- How can older people with frailty be identified at the end of life (prognostication)?
- Does early identification and intervention improve experiences and outcomes in end of life care for older adults who do not have cancer?
- When is the optimal time to identify and intervene with older people dying with frailty?
The proposed topic has been selected to support a key current policy topic following discussion with NHS England.
This review shall inform DHSC, NHS England and commissioners in primary and social care particularly, as well as a wider audience of third sector stakeholders who operate and deliver relevant services outside the NHS.
1 March 2019 to 31 August 2020