Integrated Care Models for Older Adults with Depression and Physical Comorbidity: A Scoping Review

Objective: Multimorbidity is a growing challenge in the care for older people with mental illness. To address both physical and mental illnesses, integrated care management is required. The purpose of this scoping review is to identify core components of integrated care models for older adults with depression and physical comorbidity, and map reported outcomes and implementation strategies. Methods: PubMed, EMBASE, CINAHL and Cochrane Library were searched independently by two reviewers for studies concerning integrated care interventions for older adults with depression and physical comorbidity. We used the SELFIE framework to map core components of integrated care models. Clinical and organisational outcomes were mapped. Results: Thirty-eight studies describing thirteen care models were included. In all care models, a multidisciplinary team was involved. The following core components were mainly described: continuity, person-centredness, tailored holistic assessment, pro-activeness, treatment interaction, individualized care planning, and coordination tailored to complexity of care needs. Twenty-seven different outcomes were evaluated, with more attention given to clinical than to organisational outcomes. Conclusion: The core components that comprise integrated care models are diverse. Future studies should focus more on implementation aspects of the intervention and describe financial parts, e.g., the cost of the intervention for the healthcare user, more transparently

Integrated care models for older adults with depression and physical multimorbidity: a scoping review.

By conducting this scoping review, we will map the literature on integrated care models for older adults with depression and physical multimorbidity. Effective management of multimorbidity requires integrated care, so that common risk factors and the bidirectional interaction between physical and mental illness, and the treatment for each, can be addressed together. Although more than two thirds of the older patients attending a psychiatric service have at least one physical comorbidity, little evidence is available on integrated care models for the management of care in this specific population. The aim of this review is to get a thorough overview of the existing care models. This will be the first scoping review that provides a summary on the literature in this specific domain. Moreover, we aim to develop an integrated care model for older adults with depression and physical multimorbidity by using the insights of this scoping review