An exploration of experts’ perceptions on the use of interprofessional education to support collaborative practice in the care of community-living older adults

<p>Globally, as older adults are living longer and with more chronic conditions, there is a need to support their ability to age optimally in their homes and communities. Community-based interprofessional teams working closely with these older adults, their families, and informal caregivers will be instrumental in achieving this goal. Interprofessional education (IPE) is the means through which these teams can develop expertise in collaboratively working together with older adults. However, most IPE occurs in academic settings, and acute and long-term care sectors and little is known about IPE in the context of home and community care of older adults. The purpose of this study was to describe perceptions of academic and practice experts related to the current state of IPE in home and community care of older adults and the changes that are necessary to meet the future needs of practitioners and older adults. Using a qualitative descriptive design, interviews were conducted with 32 national and international key informants representing practitioners, educators, researchers, and health system decision-makers in the field of IPE. Thematic analysis of the data identified six themes: (a) client and family-centred care at the core of IPE, (b) the community as a unique learning setting across the learning continuum; (c) an aging-relevant IPE curriculum; (d) faculty commitment and resources for IPE; (e) technological innovation to support IPE; and (f) comprehensive IPE programme evaluation and research. These findings are explored through the lens of an interprofessional learning continuum model. The article concludes with a discussion of the study implications for IPE practice and research specifically in the care of community-living older adults.</p

Assessing the impact of a home-based stroke rehabilitation programme: a cost-effectiveness study

<p><b>Background:</b> Stroke is often a severe and debilitating event that requires ongoing rehabilitation. The Community Stroke Rehabilitation Teams (CSRTs) offer home-based stroke rehabilitation to individuals for whom further therapy is unavailable or inaccessible. The objective of this study was to evaluate the cost-effectiveness of the CSRT programme compared with a “Usual Care” cohort.</p> <p><b>Methods:</b> We collected data on CSRT clients from January 2012 to February 2013. Comparator data were derived from a study of stroke survivors with limited access to specialised stroke rehabilitation. Literature-derived values were used to inform a long-term projection. Using Markov modelling, we projected the model for 35 years in six-month cycles. One-way, two-way, and probabilistic sensitivity analyses were performed. Results were discounted at 3% per year.</p> <p><b>Results:</b> Results demonstrated that the CSRT programme has a net monetary benefit (NMB) of $43,655 over Usual Care, and is both less costly and more effective (incremental cost = −$17,255; incremental effect = 1.65 Quality Adjusted Life Years [QALYs]). Results of the probabilistic sensitivity analysis revealed that incremental cost-effectiveness of the CSRT programme is superior in 100% of iterations when compared to Usual Care.</p> <p><b>Conclusions:</b> The study shows that CSRT model of care is cost-effective, and should be considered when evaluating potential stroke rehabilitation delivery methods.Implications for Rehabilitation</p><p>Ongoing rehabilitation following stroke is imperative for optimal recovery.</p><p>Home-based specialised stroke rehabilitation may be an option for individuals for whom ongoing rehabilitation is unavailable or inaccessible.</p><p>The results of this study demonstrated that home-based rehabilitation is a cost-effective means of providing ongoing rehabilitation to individuals who have experienced a stroke.</p><p></p> <p>Ongoing rehabilitation following stroke is imperative for optimal recovery.</p> <p>Home-based specialised stroke rehabilitation may be an option for individuals for whom ongoing rehabilitation is unavailable or inaccessible.</p> <p>The results of this study demonstrated that home-based rehabilitation is a cost-effective means of providing ongoing rehabilitation to individuals who have experienced a stroke.</p

Additional file 1: Appendix 1. of Patterns of health service use in community living older adults with dementia and comorbid conditions: a population-based retrospective cohort study in Ontario, Canada

Diagnostic Definitions for Index Condition (Dementia) and Co-morbid Conditions. (PDF 201 kb

Additional file 2: Appendix 2. of Patterns of health service use in community living older adults with dementia and comorbid conditions: a population-based retrospective cohort study in Ontario, Canada

Costing Methods and Data Sources. (PDF 83 kb

Additional file 1: of The Aging, Community and Health Research Unit—Community Partnership Program for older adults with type 2 diabetes and multiple chronic conditions: a feasibility study

STROBE Statement—checklist of items that should be included in reports of observational studies. (PDF 31 kb

Additional file 1: of The ACHRU-CPP versus usual care for older adults with type-2 diabetes and multiple chronic conditions and their family caregivers: study protocol for a randomized controlled trial

ACHRU-CPP: SPIRIT Checklist. (PDF 96 kb

Additional file 3: of The ACHRU-CPP versus usual care for older adults with type-2 diabetes and multiple chronic conditions and their family caregivers: study protocol for a randomized controlled trial

ACHRU-CPP: Fidelity Checklist. (PDF 87 kb