{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:37:34Z","timestamp":1792798654633,"version":"4.5.0"},"reference-count":52,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"unspecified","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["WKC-EOLC-K19002"],"award-info":[{"award-number":["WKC-EOLC-K19002"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute for Health Research Applied Research Collaborative South London","award":["NIHR200152"],"award-info":[{"award-number":["NIHR200152"]}],"id":[{"id":"https:\/\/ror.org\/0187kwz08","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000659","name":"Research Trainees Coordinating Centre","doi-asserted-by":"publisher","award":["ICA-CDRF-2017-03-012"],"award-info":[{"award-number":["ICA-CDRF-2017-03-012"]}],"id":[{"id":"10.13039\/501100000659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["CDF-2017-10-009"],"award-info":[{"award-number":["CDF-2017-10-009"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["ICA-SCL-2015-01-001"],"award-info":[{"award-number":["ICA-SCL-2015-01-001"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["ICA-SCL-2018-04-ST2-001"],"award-info":[{"award-number":["ICA-SCL-2018-04-ST2-001"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000377","name":"Dunhill Medical Trust","doi-asserted-by":"publisher","award":["RPGF1906\\177"],"award-info":[{"award-number":["RPGF1906\\177"]}],"id":[{"id":"10.13039\/501100000377","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,11,5]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Health and social care services worldwide need to support ageing populations to live well with advanced progressive conditions while adapting to functional decline and finitude. We aimed to identify and map common elements of effective geriatric and palliative care services and consider their scalability and generalisability to high, middle and low-income countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Tertiary systematic review (Cochrane Database of Systematic Reviews, CINAHL, Embase, January 2000\u2013October 2019) of studies in geriatric or palliative care that demonstrated improved quality of life and\/or health service use outcomes among older people with advanced progressive conditions. Using frameworks for health system analysis, service elements were identified. We used a staged, iterative process to develop a \u2018common components\u2019 logic model and consulted experts in geriatric or palliative care from high, middle and low-income countries on its scalability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>78 studies (59 geriatric and 19 palliative) spanning all WHO regions were included. Data were available from 17\u2009739 participants. Nearly half the studies recruited patients with heart failure (n=36) and one-third recruited patients with mixed diagnoses (n=26). Common service elements (\u226580% of studies) included collaborative working, ongoing assessment, active patient participation, patient\/family education and patient self-management. Effective services incorporated patient engagement, patient goal-driven care and the centrality of patient needs. Stakeholders (n=20) emphasised that wider implementation of such services would require access to skilled, multidisciplinary teams with sufficient resource to meet patients\u2019 needs. Identified barriers to scalability included the political and societal will to invest in and prioritise palliative and geriatric care for older people, alongside geographical and socioeconomic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our logic model combines elements of effective services to achieve optimal quality of life and health service use among older people with advanced progressive conditions. The model transcends current best practice in geriatric and palliative care and applies across the care continuum, from prevention of functional decline to end-of-life care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42020150252.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-048417","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T12:28:39Z","timestamp":1638361719000},"page":"e048417","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Common elements of service delivery models that optimise quality of life and health service use among older people with advanced progressive conditions: a tertiary systematic review"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9478-8932","authenticated-orcid":false,"given":"Joanne","family":"Bayly","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna E","family":"Bone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Ellis-Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"India","family":"Tunnard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuja","family":"Yaqub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4894-1689","authenticated-orcid":false,"given":"Deokhee","family":"Yi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2991-8160","authenticated-orcid":false,"given":"Kennedy B","family":"Nkhoma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Cook","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Combes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Bajwah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9653-8689","authenticated-orcid":false,"given":"Richard","family":"Harding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Nicholson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Normand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalini","family":"Ahuja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Turrillas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyuki","family":"Kizawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Morita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7580-4009","authenticated-orcid":false,"given":"Nanako","family":"Nishiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Tsuneto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Ong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene J","family":"Higginson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0034-7402","authenticated-orcid":false,"given":"Catherine J","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0189-0952","authenticated-orcid":false,"given":"Matthew","family":"Maddocks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,12,1]]},"reference":[{"key":"2024112512203669000_11.12.e048417.1","unstructured":"WHO . World report on aging and health. Geneva: World Health Organisation, 2015."},{"key":"2024112512203669000_11.12.e048417.2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001653","article-title":"Place and cause of death in centenarians: a population-based observational study in England, 2001 to 2010","volume":"11","author":"Evans","year":"2014","journal-title":"PLoS Med"},{"key":"2024112512203669000_11.12.e048417.3","unstructured":"Nations, U . World population prospects: the 2015 revision, key findings and advance tables. Rep No. ESA\/P\/WP. 241 2015."},{"key":"2024112512203669000_11.12.e048417.4","unstructured":"WHO . Ageing and health, 2018. Available: http:\/\/www.who.int\/news-room\/fact-sheets\/detail\/ageing-and-health"},{"key":"2024112512203669000_11.12.e048417.5","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","article-title":"Frailty in elderly people","volume":"381","author":"Clegg","year":"2013","journal-title":"The Lancet"},{"key":"2024112512203669000_11.12.e048417.6","unstructured":"World, H., Organisation . Universal health coverage (UHC), 2020. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/universal-health-coverage-(uhc)"},{"key":"2024112512203669000_11.12.e048417.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2004.06.009"},{"key":"2024112512203669000_11.12.e048417.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2008.05.004"},{"key":"2024112512203669000_11.12.e048417.9","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2007.0216"},{"key":"2024112512203669000_11.12.e048417.10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1011024"},{"key":"2024112512203669000_11.12.e048417.11","unstructured":"WPCA and who, global atlas of palliative care at the end of life. 2014, world palliative care alliance: London www-who_-int_nmh_global_atlas_of_palliative_care.pdf (genethique.org)"},{"key":"2024112512203669000_11.12.e048417.12","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.12373"},{"key":"2024112512203669000_11.12.e048417.13","doi-asserted-by":"crossref","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement","volume":"4","author":"Moher","year":"2015","journal-title":"Syst Rev"},{"key":"2024112512203669000_11.12.e048417.14","unstructured":"Rohwer A , Booth A , Pfadenhauer L . Guidance on the use of logic models in health technology assessments of complex interventions. International Journal of Technology Assessment in Health Care 2016 core.ac.uk"},{"key":"2024112512203669000_11.12.e048417.15","unstructured":"Popay J , Roberts H , Sowden A . Guidance on the conduct of narrative synthesis in systematic reviews: a product from the ESRC methods programme 2006 Guidance on the conduct of narrative synthesis in sytematic reviews \u2014 Teesside University's Research Portal"},{"key":"2024112512203669000_11.12.e048417.16","doi-asserted-by":"publisher","DOI":"10.1177\/0269216317701890"},{"key":"2024112512203669000_11.12.e048417.17","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1002\/(SICI)1099-1743(199705\/06)14:3<153::AID-SRES134>3.0.CO;2-H","article-title":"Reflecting on SSM: the link between root definitions and conceptual models","volume":"14","author":"Checkland","year":"1997","journal-title":"Systems Research and Behavioral Science"},{"key":"2024112512203669000_11.12.e048417.18","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g1687"},{"key":"2024112512203669000_11.12.e048417.19","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12282"},{"key":"2024112512203669000_11.12.e048417.20","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-021194"},{"key":"2024112512203669000_11.12.e048417.21","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14782"},{"key":"2024112512203669000_11.12.e048417.22","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1111\/jgs.14025","article-title":"Common components of efficacious in-home end-of-life care programs: a review of systematic reviews","volume":"64","author":"Bainbridge","year":"2016","journal-title":"J Am Geriatr Soc"},{"key":"2024112512203669000_11.12.e048417.23","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-7-10"},{"key":"2024112512203669000_11.12.e048417.24","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"2024112512203669000_11.12.e048417.25","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/dar097"},{"key":"2024112512203669000_11.12.e048417.26","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0552-5"},{"key":"2024112512203669000_11.12.e048417.27","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1111\/jgs.14889","article-title":"Home- and community-based occupational therapy improves functioning in frail older people: a systematic review","volume":"65","author":"De Coninck","year":"2017","journal-title":"J Am Geriatr Soc"},{"key":"2024112512203669000_11.12.e048417.28","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.eurger.2015.10.007","article-title":"Frailty and comprehensive geriatric assessment organized as CGA-ward or CGA-consult for older adult patients in the acute care setting: a systematic review and meta-analysis","volume":"6","author":"Ekdahl","year":"2015","journal-title":"Eur Geriatr Med"},{"key":"2024112512203669000_11.12.e048417.29","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011129.pub2"},{"key":"2024112512203669000_11.12.e048417.30","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.16840"},{"key":"2024112512203669000_11.12.e048417.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.05.055"},{"key":"2024112512203669000_11.12.e048417.32","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.11.1358"},{"key":"2024112512203669000_11.12.e048417.33","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12028"},{"key":"2024112512203669000_11.12.e048417.34","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s00520-017-3895-1","article-title":"The impact of specialized palliative care on cancer patients' health-related quality of life: a systematic review and meta-analysis","volume":"26","author":"Kassianos","year":"2018","journal-title":"Support Care Cancer"},{"key":"2024112512203669000_11.12.e048417.35","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000014867","article-title":"Collaborative care intervention for patients with chronic heart failure: a systematic review and meta-analysis","volume":"98","author":"Cui","year":"2019","journal-title":"Medicine"},{"key":"2024112512203669000_11.12.e048417.36","doi-asserted-by":"publisher","DOI":"10.1177\/0269216318812633"},{"key":"2024112512203669000_11.12.e048417.37","unstructured":"Sezgin D OCR , Liew A , O\u2019 Donovan M . On behalf of work package 7 partners, Intermediate care interventions for older adults. Health Programme of the European Union, NHS Lanarkshire 2019."},{"key":"2024112512203669000_11.12.e048417.38","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1093\/ageing\/afy145","article-title":"New horizons in the compression of functional decline","volume":"47","author":"Gore","year":"2018","journal-title":"Age Ageing"},{"key":"2024112512203669000_11.12.e048417.39","unstructured":"Organization, W.H . Integrated care for older people: guidelines on community-level interventions to manage declines in intrinsic capacity. Geneva: Organization, W.H, 2017."},{"key":"2024112512203669000_11.12.e048417.40","doi-asserted-by":"crossref","first-page":"e883","DOI":"10.1016\/S2214-109X(19)30172-X","article-title":"The escalating global burden of serious health-related suffering: projections to 2060 by world regions, age groups, and health conditions","volume":"7","author":"Sleeman","year":"2019","journal-title":"Lancet Glob Health"},{"key":"2024112512203669000_11.12.e048417.41","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijnurstu.2021.103978","article-title":"Community-Based short-term integrated palliative and supportive care reduces symptom distress for older people with chronic noncancer conditions compared with usual care: a randomised controlled single-blind mixed method trial","volume":"120","author":"Evans","year":"2021","journal-title":"Int J Nurs Stud"},{"key":"2024112512203669000_11.12.e048417.42","doi-asserted-by":"crossref","DOI":"10.5334\/ijic.67","article-title":"Integrated care: meaning, logic, applications, and implications--a discussion paper","volume":"2","author":"Kodner","year":"2002","journal-title":"Int J Integr Care"},{"key":"2024112512203669000_11.12.e048417.43","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1080\/08959420.2020.1759759","article-title":"COVID-19: implications for the support of people with social care needs in England","volume":"32","author":"Comas-Herrera","year":"2020","journal-title":"J Aging Soc Policy"},{"key":"2024112512203669000_11.12.e048417.44","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-016-0746-8"},{"key":"2024112512203669000_11.12.e048417.45","unstructured":"Humphries R , Thorlby R , Holder H , et al . Social care for older people: home truths. London: King\u2019s Fund, 2016."},{"key":"2024112512203669000_11.12.e048417.46","unstructured":"Robinson, L. and G.O.f.S . Present and future configuration of health and social care services to enhance robustness in older age. London: Foresight, Government Office for Science, 2015."},{"key":"2024112512203669000_11.12.e048417.47","doi-asserted-by":"crossref","unstructured":"Colombo F et al . Help wanted? Providing and paying for long-term care OECD health policy studies. Paris: OECD Publishing, 2011.","DOI":"10.1787\/9789264097759-en"},{"key":"2024112512203669000_11.12.e048417.48","doi-asserted-by":"crossref","unstructured":"Tiberini R , Turner K , Talbot-Rice H . Rehabilitation in palliative care, in textbook of palliative care. Cham: Springer, 2018: 1\u201329.","DOI":"10.1007\/978-3-319-31738-0_34-1"},{"key":"2024112512203669000_11.12.e048417.49","doi-asserted-by":"crossref","first-page":"S164","DOI":"10.21037\/apm.2018.06.07","article-title":"What are the main palliative care symptoms and concerns of older people with multimorbidity?-a comparative cross-sectional study using routinely collected Phase of Illness, Australia-modified Karnofsky performance status and integrated palliative care outcome scale data","volume":"7","author":"Nicholson","year":"2018","journal-title":"Ann Palliat Med"},{"key":"2024112512203669000_11.12.e048417.50","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2026141"},{"key":"2024112512203669000_11.12.e048417.51","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1177\/02692163211015574","article-title":"Early, integrated palliative rehabilitation improves quality of life of patients with newly diagnosed advanced cancer: the Pal-Rehab randomized controlled trial","volume":"35","author":"Nottelmann","year":"2021","journal-title":"Palliat Med"},{"key":"2024112512203669000_11.12.e048417.52","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001690"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2020-048417","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T15:20:57Z","timestamp":1732548057000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2020-048417"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":52,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,12,1]]},"published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1136\/bmjopen-2020-048417"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2020-048417","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}