General practitioner-based interventions to reduce hospital admissions in patients with multimorbidity living at home - A rapid review.

Abstract

Background: Multimorbidity is a common health problem among patients treated in GP practices and often associated with an increased risk of hospitalization. The aim of this review was to identify GP-based interventions to reduce hospitalization in patients with multimorbidity who were evaluated in randomized controlled trials.

Methods: For the rapid review, the databases Medline and CENTRAL were systematically searched for randomized controlled trials evaluating an effect of GP-based interventions on the duration or frequency of hospitalization in adult patients with multimorbidity living at home. The interventions and their effects were described narratively.

Results: From 2,260 hits in the database searches, 15 studies could be included. The interventions identified included, amongst others, interdisciplinary cooperation, training of GPs and other practice staff, and increased patient centeredness. Hospital admissions were reported in 13 studies, and the number of days spent in hospital was reported in six studies. Two studies found a significant reduction in hospitalization.

Conclusions: While most interventions were not effective, there were also two GP-based interventions for patients with multimorbidity which focused on the patients' individual situation and contributed to avoiding hospitalization. However, more studies are needed to make reliable statements on the effectiveness of various measures.