which also assisted with notification of address changes. 12. Telephone services with nurses was inconsistent due to financial restraint Barriers to screening for IPV: home visitors’ fear of either being a victim of violence from the abusive partner or having the client withdraw from HV because discussing IPV would be too sensitive and intrusive for participants. Tappenden et al. (2012) 1. Nurse led health 4. Adults >65 (n=5850). 8. Admission to hospital, 10. There is a dearth of 13. Given the limitations of promotion activities residential or nursing care, good-quality economic the current evidence base, UK. described as a complex 5. Long-term mortality, morbidity including studies available to it remains unclear whether intervention. medical/social needs at depression, falls, accidents, inform decisions about home-based health Systematic Review. (n=14 – risk of admission to deteriorating health status, the cost effectiveness promotion interventions 11 RCTs and 3 economic 2. Nurse led health hospital, residential or patient satisfaction. Outcomes of home-based, offer good value for money. evaluations). promotion. nursing care e.g. heart measured and reported led health promotion. disease, Parkinson’s differently between studies At best a weak 14. Recommended To evaluate the clinical and 3. (a) health education, disease, stroke, venous leg preventing meta-analysis. suggestion that the appropriate training of economic effectiveness of involving communication ulcers. cost-effectiveness may nurses, and potentially home-based, nurse-led directed at individuals, 9. Mortality: reduced the risk of be dependent on the other elements of a health promotion families and communities 6. Home. death [odds ratio (OR) = 0.80, population at whom multidisciplinary team, but programmes in the UK. to influence; (b) service 95% confidence interval (CI) the programme is may have considerable improvement, involving 7. Trained nurses / health 0.68 to 0.95]. targeted. implications in terms of quality and quantity of visitors with access to MDT. costs and capacity. service; and (c) advocacy Also statistically significant 11.NR. involving agenda-setting effects favouring the There may be a role for for healthy public policy. intervention on Leg ulcer 12.NR. qualitative research in
which also assisted with notification of address changes. 12. Telephone services with nurses was inconsistent due to financial restraint Barriers to screening for IPV: home visitors’ fear of either being a victim of violence from the abusive partner or having the client withdraw from HV because discussing IPV would be too sensitive and intrusive for participants. Tappenden et al. (2012) UK. Systematic Review. (n=14 – 11 RCTs and 3 economic evaluations). To evaluate the clinical and economic effectiveness of home-based, nurse-led health promotion programmes in the UK. 1. Nurse led health promotion activities described as a complex intervention. 2. Nurse led health promotion. 3. (a) health education, involving communication directed at individuals, families and communities to influence; (b) service improvement, involving quality and quantity of service; and (c) advocacy involving agenda-setting for healthy public policy. 4. Adults >65 (n=5850). 5. Long-term medical/social needs at risk of admission to hospital, residential or nursing care e.g. heart disease, Parkinson’s disease, stroke, venous leg ulcers. 6. Home. 7. Trained nurses / health visitors with access to MDT. 8. Admission to hospital, residential or nursing care, mortality, morbidity including depression, falls, accidents, deteriorating health status, patient satisfaction. Outcomes measured and reported differently between studies preventing meta-analysis. 9. Mortality: reduced the risk of death [odds ratio (OR) = 0.80, 95% confidence interval (CI) 0.68 to 0.95]. Also statistically significant effects favouring the intervention on Leg ulcer 10. There is a dearth of good-quality economic studies available to inform decisions about the cost effectiveness of home-based, health promotion. At best a weak suggestion that the cost-effectiveness may be dependent on the population at whom the programme is targeted. 11.NR. 12.NR. 13. Given the limitations of the current evidence base, it remains unclear whether home-based health promotion interventions offer good value for money. 14. Recommended appropriate training of nurses, and potentially other elements of a multidisciplinary team, but may have considerable implications in terms of costs and capacity. There may be a role for qualitative research in led
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