Personalised care planning for older people with frailty : a review of factors influencing implementation

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HEAVEN, Anne | FOSTER, Marilyn | FOY, Robbie | HAWKINS, Rebecca | HULME, Claire | HUMPHREY, Sara | SMITH, Jane E. | CLEGG, Andrew Paul

BACKGROUND: Frailty increases vulnerability to major health changes because of seemingly small health problems. It affects around 10% of people aged over 65.Older adults with frailty frequently have multiple long-term conditions, personal challenges, and social problems. Personalised Care Planning (PCP) based on 'goal-setting' and 'action planning' is a promising way to address the needs of older adults living with frailty. AIM: To identify and explore factors that influence the implementation of personalised care planning style interventions for older adults. DESIGN & SETTING: We conducted a scoping review and identified a small number of interventions that explicitly employed 'goal setting' and 'action planning'. METHOD: We used a range of sources to identify relevant material. We included all interventions inclusive of patients aged 65 and over and reported in English. We excluded end-of-life care interventions, group education and/or, those that did not involve one-to-one engagement. We explored all related papers which described, examined, or discussed implementation. We constructed a thematic framework in NVivo 11. Findings were narratively synthesised. RESULTS: We identified 18 potentially relevant PCP-style interventions. Within these, were seven main categories of potentially modifiable influences relevant to older adults with frailty related to: Primary care engagement; Delivery staff characteristics; Training; Client engagement; Collaborative working; Organisation and management; Systems. CONCLUSIONS: Many modifiable factors can influence the implementation of PCP. We identified several influences which have informed the development and implementation of a novel intervention for older adults with frailty, PROSPER.

http://dx.doi.org/10.3399/BJGPO.2024.0163

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