title: Discharge interventions for older patients leaving hospital: protocol for a systematic meta-review.
abstract: BACKGROUND
  There is an increased need for additional care and support services for the elderly population. It is important to identify what support older people need once they are discharged from hospital and to ensure continuity of care. There is a large evidence base focusing on enhanced discharge services and their impact on patients. The services show some potential benefits, but there are inconsistent findings across reviews. Furthermore, it is unclear what elements of enhanced discharge interventions could be most beneficial to older people. This meta-review aims to identify existing systematic reviews of discharge interventions for older people, identify potentially effective elements of enhanced discharge services for this patient group and identify areas where further work may still be needed.
  
  
  METHODS
  The search will aim to identify English language systematic reviews that have assessed the effectiveness of discharge interventions for older people. The following databases will be searched: Medline, Embase, PsycINFO, HMIC, Social Policy and Practice, CINAHL, the Cochrane Library, ASSIA, Social Science Citation Index and the Grey Literature Report. The search strategy will comprise the keywords 'systematic reviews', 'older people' and 'discharge'. Discharge interventions must aim to support older patients before, during and/or after discharge from hospital. Outcomes of interest will include mortality, readmissions, length of hospital stay, patient health status, patient and carer satisfaction and staff views. Abstract, title and full text screening will be conducted independently by two reviewers. Data extracted from reviews will include review characteristics, patient population, review quality score, outcome measures and review findings, and a narrative synthesis will be conducted.
  
  
  CONCLUSIONS
  This review will identify existing reviews of discharge interventions and appraise how these interventions can impact outcomes in older people such as readmissions, health status, length of hospital stay and mortality. The review could inform practice and will help identify where further research is needed.
  
  
  BACKGROUND
  PROSPERO CRD42015025737.
authors.affiliation: NIHR CLAHRC West Midlands - Theme 4 Chronic Diseases, School of Health & Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. EXO421@bham.ac.uk.
authors.forename: Elaine
authors.initials: E
authors.lastname: O'Connell Francischetto
authors.affiliation: NIHR CLAHRC West Midlands - Theme 4 Chronic Diseases, School of Health & Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Damery
authors.affiliation: Behavioural Brain Sciences Unit, Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Davies
authors.affiliation: NIHR CLAHRC West Midlands - Theme 4 Chronic Diseases, School of Health & Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
authors.forename: Gill
authors.initials: G
authors.lastname: Combes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006304:Health Status; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008875:Middle Aged; D009026:Mortality; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011788:Quality of Life; D012196:Review Literature as Topic; D000078202:Systematic Reviews as Topic
keywords: Hospital discharge; Meta-review; Older people; Review of reviews