Table 1.

Characteristics of included studies.

Authors (Year) Study Design [Ref]	Country Setting	Sample	Interventions				Control	Follow-Up Period	Primary and Secondary Outcome
			Education Training	Consultation (APN) and Guidance	Change Policy Implementation Guideline	Availability Alternative Intervention
Abraham et al. (2019) [27] Pragmatic RCT	Germany 120 NH	N = 12,245 residents IG 1: 4126 IG 2: 3547 CG: 4572	✓		✓	✓	Usual care	6–12 months	Physical restraint use Falls Fall -related fractures Quality of life
Capezuti et al. (2002) [39] Pre- and posttest design	USA 4NH	N = 251 residents (side rail use) IG: N = 130 Discontinued Side Rail Use IG: N = 121 Continued Side Rail Use		✓			Usual care	1–12 months	Side rail use Incidence of falls
Evans et al. (1997) [28] Cluster randomized trial	USA 3 NH	N = 643 residents N = 463 complete data IGa: 152 IGb: 127 CG: 184	✓	✓			Usual care	6–9–12 months	Physical restraint use Restraint intensity Fall rate
Gulpers et al. (2011) [37] Quasi-experimental longitudinal design	Netherlands 26 psycho-geriatric NH	N = 420 residents N = 405 complete data IG: 250 CG:155	✓	✓	✓	✓	Usual care	4–8 months	Belt restraint use Other types of physical restraint use Use of Psychoactive drugs f Falls Fall-related injuries
Gulpers et al. (2012) [38] Quasi-experimental longitudinal study	Netherlands 13 NH	N = 104 newly admitted residents N = 82 complete data base line IG: t0 43–t1 29 CG: t0 39–t1 20	✓	✓	✓	✓	Usual Care	4–8 months	Belt restraints use e Other types of physical restrains use Use of psychoactive medication Falls Fall-related injuries
Gulpers et al. (2013) [36] Quasi-experimental longitudinal study	Netherlands 13 NH	N = 225 panel group IG: N = 134 CG: N = 91	✓	✓	✓	✓	Usual care	24 months	belt restraints use Use of at least one physical restraint device
Huizing et al. (2006) [29] Cluster randomized trial	Netherlands 5 psycho-geriatric NH	N = 145 residents with dementia N = 126 complete data IG: t0 83–t1 86 CG: t0 62–t1 58	✓	✓			Usual care	1 month	Physical restraint use Restraint intensity Restraint type
Huizing et al. (2009a) [30] Cluster randomized trial	Dutch 7 psycho-geriatric NH	N = 432 psycho geriatric residents N = 241 complete data IG: N = 125 CG: N = 115	✓	✓			Usual Care	1–4–8 months	Physical restraint status, intensity Multiple restraint use
Huizing et al. (2009b) [31] Cluster randomized trial	Dutch 14 psycho-geriatric NH	N = 138 newly admitted psychogeriatric residents N = 90 complete data base line IG: 53 CG: 37	✓	✓			Usual Care	1–4–8 months	Physical restraint status, intensity Multiple restraint use
Koczy et al. (2011) [32] Cluster randomized trial	Germany 45 NH	N = 430 restrained residents N = 333 complete data IG: N = 208 CG: N = 125	✓	✓		✓	Usual care	3 months	Cessation of physical restraints (100%)–bed rails were not included Falls Use of psychoactive medication
Köpke et el. (2012) [15] Cluster randomized trial	Germany 18 NH	N = 4449 residents IG: N = 2283 CG: N = 2166	✓		✓		Standard information	3–6 months	Physical restraint use (6 month) Physical restraint use (3 month) Falls Fall-related fractures Use of antipsychotropic therapy
Pellfolk et al. (2010) [9] Cluster-randomized controlled trial	Sweden 40 Units for people dementia	N = 355 residents N = 350 residents complete data IG: Residents, N = 192 CG: Residents, N = 163	✓				Usual care	6 months	Physical restraint use Falls (1 months) Use of antipsychotic therapy (Benzodiazepines–Narcoleptics)
Rovner et al. (1996) [35] Randomized controlled Trial (RCT)	Baltimore (USA) A 250-bed community NH	N = 89 residents randomized N = 81 complete data (91%) IG: N = 42 CG: N = 39	✓				Usual care	6 months	Behavioral disorders Use of antipsychotic drugs Physical restraint use Cognition and level of nursing care
Testad (2005) [33] single-blind cluster Randomised controlled trial	Norway 4NH	N = 151 residents IG: N = 55 residents All complete data CG: N = 96 residents N = 87 complete data	✓				Usual care	7 months	Physical restraint use Agitation
Testad et al. (2010) [34] Single blind cluster randomized controlled trial	Norway 4NH	N = 211 residents IG: N = 113 residents N = 76–44 complete data CG: N = 98 residents N = 46 complete data	✓				Usual care	6–12 months	Structural restraint Interactional restraint (treatment and care giving activity such as force and pressure) Agitation Use of antipsychotic drugs
Testad et al. (2016) [26] Single-blind cluster randomized controlled trial	Norway 24 care homes (citated by authors as NH)	N = 274 residents IG: N = 118 residents with dementia N = 85 complete data CG: N = 156 residents N = 116 complete data	✓				Usual care	7 months	Physical restraint use Agitation Use of antipsychotic drugs

N = number of residents recruited at baseline; Complete data = residents at study endpoint; NH = nursing home; IG = intervention group; CG = control group.