Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.
BMC Geriatr. 2012 Jun 25;12:31. doi: 10.1186/1471-2318-12-31.
A thorough understanding of the literature generated from research in care homes is required to support evidence-based commissioning and delivery of healthcare. So far this research has not been compiled or described. We set out to describe the extent of the evidence base derived from randomized controlled trials conducted in care homes.
A systematic mapping review was conducted of the randomized controlled trials (RCTs) conducted in care homes. Medline was searched for "Nursing Home", "Residential Facilities" and "Homes for the Aged"; CINAHL for "nursing homes", "residential facilities" and "skilled nursing facilities"; AMED for "Nursing homes", "Long term care", "Residential facilities" and "Randomized controlled trial"; and BNI for "Nursing Homes", "Residential Care" and "Long-term care". Articles were classified against a keywording strategy describing: year and country of publication; randomization, stratification and blinding methodology; target of intervention; intervention and control treatments; number of subjects and/or clusters; outcome measures; and results.
3226 abstracts were identified and 291 articles reviewed in full. Most were recent (median age 6 years) and from the United States. A wide range of targets and interventions were identified. Studies were mostly functional (44 behaviour, 20 prescribing and 20 malnutrition studies) rather than disease-based. Over a quarter focussed on mental health.
This study is the first to collate data from all RCTs conducted in care homes and represents an important resource for those providing and commissioning healthcare for this sector. The evidence-base is rapidly developing. Several areas - influenza, falls, mobility, fractures, osteoporosis - are appropriate for systematic review. For other topics, researchers need to focus on outcome measures that can be compared and collated.
为了支持基于证据的医疗保健委托和交付，需要彻底了解养老院研究产生的文献。到目前为止，这项研究还没有被编纂或描述。我们旨在描述从养老院进行的随机对照试验中得出的证据基础的范围。
对养老院进行的随机对照试验（RCT）进行了系统映射审查。在 Medline 中搜索了“Nursing Home”、“Residential Facilities”和“Homes for the Aged”；在 CINAHL 中搜索了“nursing homes”、“residential facilities”和“skilled nursing facilities”；在 AMED 中搜索了“Nursing homes”、“Long term care”、“Residential facilities”和“Randomized controlled trial”；在 BNI 中搜索了“Nursing Homes”、“Residential Care”和“Long-term care”。文章根据描述以下内容的关键字策略进行分类：发表年份和国家；随机化、分层和盲法方法；干预目标；干预和对照治疗；受试者和/或群组数量；结局测量指标；结果。
共确定了 3226 篇摘要，并对 291 篇全文进行了审查。大多数是最近的（中位数年龄 6 岁），来自美国。确定了广泛的目标和干预措施。研究主要是针对功能的（44 项行为研究、20 项处方研究和 20 项营养不良研究），而不是基于疾病的研究。超过四分之一的研究关注心理健康。
这项研究首次汇集了所有在养老院进行的 RCT 的数据，为为该部门提供和委托医疗保健的人员提供了重要资源。证据基础正在迅速发展。一些领域——流感、跌倒、移动性、骨折、骨质疏松症——适合进行系统评价。对于其他主题，研究人员需要关注可以进行比较和整理的结局测量指标。
