Systematic scoping review of frameworks used to develop rehabilitation interventions for older adults

Vicky Booth, Victoria Hood-Moore, Jennie E Hancox, Phillipa Logan, Katie R Robinson, Vicky Booth, Victoria Hood-Moore, Jennie E Hancox, Phillipa Logan, Katie R Robinson

Abstract

Objectives: Rehabilitation interventions for older adults are complex as they involve a number of interacting components, have multiple outcomes of interest and are influenced by a number of contextual factors. The importance of rigorous intervention development prior to formal evaluation has been acknowledged and a number of frameworks have been developed. This review explored which frameworks have been used to guide the development of rehabilitation interventions for older adults.

Design: Systematic scoping review.

Setting: Studies were not limited for inclusion based on setting.

Participants: Studies were included that featured older adults (>65 years of age).

Interventions: Studies were included that reported the development of a rehabilitation intervention.

Primary and secondary outcome measures: Data were extracted on study population, setting, type of intervention developed and frameworks used. The primary outcome of interest was the type of intervention development framework.

Results: Thirty-five studies were included. There was a range of underlying medical conditions including mild cognitive impairment and dementia (n=5), cardiac (n=4), stroke (n=3), falls (n=3), hip fracture (n=2), diabetes (n=2), breast cancer (n=1), Parkinson's disease (n=1), depression (n=1), chronic health problems (n=1), osteoarthritis (n=1), leg ulcer (n=1), neck pain (n=1) and foot problems (n=1). The intervention types being developed included multicomponent, support based, cognitive, physical activities, nursing led, falls prevention and occupational therapy led. Twelve studies (34%) did not report using a framework. Five frameworks were reported with the Medical Research Council (MRC) framework for developing and evaluating complex interventions being the most frequently cited (77%, n=17).

Conclusion: At present, the MRC framework is the most popular for developing rehabilitation interventions for older adults. Many studies do not report using a framework. Further, specific guidance to assist this complex field of rehabilitation research is required.

Keywords: intervention development; older adults; rehabilitation; rehabilitation medicine.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Flow diagram depicting the number of studies identified and excluded at each stage (each stage of the review process is depicted by a box in a sequential design as suggested by PRISMA-ScR12). PRISMA-ScR, Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.

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