BMJ 2000;320:754-758 ( 18 March )

General Practice

Effects of preventive home visits to elderly people living in the community: systematic review

Jolanda C M van Haastregt, health scientist, ^a Jos P M Diederiks, associate professor, ^b Erik van Rossum, associate professor, ^c Luc P de Witte, executive director, ^a Harry F J M Crebolder, professor. ^d

^a Research Division, Institute for Rehabilitation Research, PO Box 192, 6430 AD Hoensbroek, Netherlands, ^b Department of Medical Sociology, Maastricht University, PO Box 616, 6200 MD Maastricht, Netherlands, ^c Department of Epidemiology, Maastricht University, ^d Department of General Practice, Maastricht University

Correspondence to: J C M van Haastregt jolanda.vanhaastregt{at}irv.nl

Objective: To assess the effects of preventive home visits to elderly people living in the community.
Design: Systematic review.
Setting: 15 trials retrieved from Medline, Embase, and the Cochrane controlled trial register.
Main outcome measures: Physical function, psychosocial function, falls, admissions to institutions, and mortality.
Results: Considerable differences in the methodological quality of the 15 trials were found, but in general the quality was considered adequate. Favourable effects of the home visits were observed in 5 out of 12 trials measuring physical functioning, 1 out of 8 measuring psychosocial function, 2 out of 6 measuring falls, 2 out of 7 measuring admissions to institutions, and 3 of 13 measuring mortality. None of the trials reported negative effects.
Conclusions: No clear evidence was found in favour of the effectiveness of preventive home visits to elderly people living in the community. It seems essential that the effectiveness of such visits is improved, but if this cannot be achieved consideration should be given to discontinuing these visits.

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