Table 2.
Effect of preventive primary care interventions with common practice-, provider-, and practice- and provider-focused intervention components
| Effect | All studies | Change in care setting | HP education | New info for HPs | Patient discussion | Patient negotiation | Patient education | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
| ||||||||||||||
| n | d(95% CI)a | n | d(95% CI)a | n | d(95% CI)a | n | d(95% CI)a | n | d(95% CI)a | n | d(95% CI)a | n | d(95% CI)a | |
| Healthcare use | ||||||||||||||
| Per cent admitted to hospital, OR | 8 | 1.11 (0.96 to 1.27) | 6 | 1.21 (0.96 to 1.52) | 6 | 1.08 (0.93 to 1.26) | 5 | 1.24 (1.00 to 1.54) | 5 | 1.18 (0.84 to 1.68) | 5 | 1.18 (0.84 to 1.68) | 2 | 0.69 (0.17 to 2.82) |
| Frequency of hospital admission, IRR | 5 | 0.86 (0.63 to 1.17) | 4 | 0.77 (0.63 to 0.95) | 4 | 0.95 (0.71 to 1.29) | 4 | 0.86 (0.59 to 1.23) | 3 | 0.79 (0.60 to 1.03) | 3 | 0.79 (0.60 to 1.03) | 3 | 0.74 (0.56 to 0.97) |
| Hospital LOS, ratio of duration | 3 | 1.09 (1.00 to 1.19) | — | — | 2 | 1.08 (1.00 to 1.18) | 2 | 1.42 (0.62 to 3.26) | 2 | 1.42 (0.62 to 3.26) | 2 | 1.42 (0.62 to 3.26) | — | — |
| Per cent in residential care, OR | 4 | 1.23 (0.94 to 1.61) | 3 | 1.08 (0.72 to 1.61) | 3 | 1.31 (0.99 to 1.72) | 4 | 1.23 (0.94 to 1.61) | — | — | — | — | 2 | 0.97 (0.38 to 2.48) |
|
| ||||||||||||||
| Functional ability | ||||||||||||||
| Basic ADLs | 4 | 0.21 (0.01 to 0.40) | 4 | 0.21 (0.01 to 0.40) | 4 | 0.21 (0.01 to 0.40) | 3 | 0.15 (−0.01 to 0.31) | 3 | 0.18 (−0.06 to 0.42) | 2 | 0.29 (−0.35 to 0.93) | 3 | 0.28 (0.09 to 0.48) |
| Extended ADLs | 10 | 0.04 (−0.05 to 0.14) | 8 | 0.08 (−0.01 to 0.18) | 7 | 0.03 (−0.07 to 0.13) | 9 | 0.02 (−0.07 to 0.10) | 7 | 0.02 (−0.12 to 0.15) | 6 | 0.00 (−0.16 to 0.15) | 6 | 0.09 (−0.05 to 0.22) |
|
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| Quality of life | ||||||||||||||
| Per cent reported positive SRH, OR | 6 | 1.17 (1.01 to 1.37) | 6 | 1.17 (1.01 to 1.37) | 4 | 1.27 (1.05 to 1.55) | 4 | 1.15 (0.94 to 1.39) | 5 | 1.09 (0.91 to 1.31) | 4 | 1.11 (0.89 to 1.37) | 4 | 1.15 (0.95 to 1.38) |
| SRH score | 4 | 0.03 (−0.19 to 0.25) | 3 | 0.13 (−0.04 to 0.29) | 3 | 0.03 (−0.27 to 0.33) | 4 | 0.03 (−0.19 to 0.25) | 3 | −0.05 (−0.23 to 0.13) | 3 | −0.05 (−0.23 to 0.13) | 3 | 0.13 (−0.04 to 0.29) |
| QoL index score | 6 | 0.09 (−0.07 to 0.25) | 6 | 0.09 (−0.07 to 0.25) | 4 | 0.17 (−0.05 to 0.38) | 5 | 0.09 (−0.09 to 0.26) | 5 | 0.02 (−0.08 to 0.12) | 5 | 0.02 (−0.08 to 0.12) | 4 | 0.16 (−0.11 to 0.42) |
| Physical domain score | 5 | −0.03 (−0.12 to 0.05) | 4 | −0.07 (−0.17 to 0.02) | 4 | −0.03 (−0.12 to 0.07) | 5 | −0.03 (−0.12 to 0.05) | 3 | −0.02 (−0.14 to 0.10) | 2 | −0.04 (−0.20 to 0.11) | — | — |
| Mental domain score | 5 | 0.01 (−0.07 to 0.08) | 4 | −0.02 (−0.12 to 0.08) | 4 | 0.00 (−0.09 to 0.09) | 5 | 0.01 (−0.07 to 0.08) | 3 | 0.03 (−0.09 to 0.15) | 2 | −0.01 (−0.16 to 0.14) | — | — |
a
Data are effect size d(standardised mean difference) unless otherwise indicated; all are presented with 95% confidence intervals. ADLs = activities of daily living. HP = health professional. IRR = incidence rate ratio. LOS = length of stay. OR = odds ratio. QoL = quality of life. SRH = self-rated health.