title: Systematic review of interdisciplinary interventions in nursing homes.
abstract: BACKGROUND
  The role of interdisciplinary interventions in the nursing home (NH) setting remains unclear. We conducted a systematic evidence review to study the benefits of interdisciplinary interventions on outcomes of NH residents. We also examined the interdisciplinary features of successful trials, including those that used formal teams.
  
  
  METHODS
  Medline was searched from January 1990 to August 2011. Search terms included residential facilities, long term care, clinical trial, epidemiologic studies, epidemiologic research design, comparative study, evaluation studies, meta-analysis and guideline.
  
  
  METHODS
  We included randomized controlled trials (RCTs) evaluating the efficacy of interdisciplinary interventions conducted in the NH setting.
  
  
  METHODS
  We used the Cochrane Collaboration tools to appraise each RCT, and an RCT was considered positive if its selected intervention had a significant positive effect on the primary outcome regardless of its effect on any secondary outcome. We also extracted data from each trial regarding the participating disciplines; for trials that used teams, we studied the reporting of various team elements, including leadership, communication, coordination, and conflict resolution.
  
  
  RESULTS
  We identified 27 RCTs: 7 had no statistically significant effect on the targeted primary outcome, 2 had a statistically negative effect, and 18 demonstrated a statistically positive effect. Participation of residents' own primary physicians (all 6 trials were positive) and/or a pharmacist (all 4 trials were positive) in the intervention were common elements of successful trials. For interventions that used formal team meetings, presence of communication and coordination among team members were the most commonly observed elements.
  
  
  CONCLUSIONS
  Overall interdisciplinary interventions had a positive impact on resident outcomes in the NH setting. Participation of the residents' primary physician and/or a pharmacist in the intervention, as well as team communication and coordination, were consistent features of successful interventions.
authors.affiliation: Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA. anazir@iupui.edu
authors.forename: Arif
authors.initials: A
authors.lastname: Nazir
authors.forename: Kathleen
authors.initials: K
authors.lastname: Unroe
authors.forename: Monica
authors.initials: M
authors.lastname: Tegeler
authors.forename: Babar
authors.initials: B
authors.lastname: Khan
authors.forename: Jose
authors.initials: J
authors.lastname: Azar
authors.forename: Malaz
authors.initials: M
authors.lastname: Boustani
mesh_terms: D003142:Communication; D006801:Humans; D009735:Nursing Homes; D010348:Patient Care Team / Q000458:organization & administration*; D010595:Pharmacists; D058007:Physicians, Primary Care; D016032:Randomized Controlled Trials as Topic