Technology extends the reach of community and end-of-life care only when someone accounts for who does the extra work
This week's evidence across five domains converges on one caution: extending care into the community succeeds only when someone designs for who absorbs the extra workload, not only for whether the underlying model works.
Unread 8 minWho engages with, and responds to, CBT for psychosis remains largely unpredictable, systematic review finds
A systematic review of 23 studies finds no consistent patient or service-level predictor of engagement with, or response to, cognitive behavioural therapy for psychosis.
Unread 1 minWhich components of talking therapy actually help? Large meta-analysis identifies the ones that work — and two that may not
A Bayesian component-network meta-analysis of individual participant data from 34 randomised trials identifies which specific components of task-shared psychosocial interventions, delivered by non-specialist workers, most improve outcomes for depression and anxiety.
Unread 1 minUK review finds almost no quality-assured patient education materials exist for home intravenous antibiotic therapy
A grey-literature review of 36 candidate resources for outpatient parenteral antimicrobial therapy finds only 9 met basic quality criteria, and just 2 patient-directed resources exist at all, neither formally accredited.
Unread 1 minFive factors predict who reattempts suicide within a year of a first attempt, large Spanish cohort finds
A prospective multicentre cohort study of 1,730 patients across eight Spanish hospitals finds 19.7% reattempted suicide within 12 months, with medication burden, suicidal ideation frequency, prior attempts, childhood emotional neglect and non-suicidal self-injury as independent predictors.
Unread 1 minFirst national survey finds most UK palliative virtual wards still run on phone calls, not technology, and many depend on charity funding
The first UK-wide survey of palliative virtual wards finds only 15% of 22 responding services use remote-monitoring technology, and three-quarters rely on charitable funding, with two services already closed for lack of it.
Unread 1 minFewer than half of older major trauma patients have a documented treatment escalation plan, national UK audit finds
A national point-prevalence audit across major trauma centres and trauma units in England, Wales and Scotland finds only 41% of older major trauma patients had a documented treatment escalation plan, and only a fifth of those were on a palliative or end-of-life care pathway.
Unread 1 minFalls research rarely records the same details twice, systematic review finds, and proposes a standard reporting framework
A systematic review of 75 studies finds fall-circumstance reporting is highly inconsistent and proposes a standardised '6 W's' interview and reporting framework for community-dwelling older adults.
Unread 1 minDigital tools for following up older patients after discharge are feasible and liked, but their effect on readmission remains unproven, systematic review finds
A systematic review of 46 studies finds digital health technologies for post-discharge follow-up of older adults are feasible, well-engaged with and liked by patients, but evidence on whether they reduce rehospitalisation or improve mental health is mixed.
Unread 1 minCochrane review finds little to no evidence that lumbar supports or other assistive devices help chronic low back pain
A Cochrane review of eight randomised trials finds lumbar supports offer little to no benefit alone for chronic low back pain, a small short-term pain reduction only when added to anti-inflammatory drugs, and no eligible evidence exists at all for other mobility or gait assistive devices.
Unread 1 minApathy after hip fracture surgery independently predicts poorer functional recovery, multicentre study finds
A Japanese multicentre prospective study of 65 older adults finds apathy severity after ward transfer independently predicts poorer functional recovery following hip-fracture surgery, distinct from delirium or behavioural and psychological symptoms of dementia.
Unread 1 minA national accessibility mapping method shows hospice access declining sharply outside Germany's cities, and offers a transferable way to measure it
A national study comparing four spatial-accessibility methods across 295 German inpatient hospices finds 90.3% of the population can reach a hospice within 30 minutes by car, but accessibility declines sharply in rural areas once distance-decay is accounted for.
Unread 1 minA five-year, 887-patient study finds high satisfaction with telemedicine-based hospital-at-home care, but does not measure whether it saves clinical resource
A large real-world cohort study of 887 patients over nearly five years finds very high patient satisfaction and perceived safety in a telemedicine-based, virtual-first hospital-at-home programme.
Unread 1 minDeprivation and rurality are active drivers of worse outcomes — and AI clinical tools risk adding a new one
This month's deep dive finds deprivation and rurality behaving as active, independent drivers of worse clinical outcomes across four countries and four domains, alongside an emerging technology-mediated equity risk in AI-enabled clinical documentation tools that has not yet been matched by a mandatory pre-deployment safeguard.
Unread 20 minReducing contact frequency, not clinical scope, is the dominant lever for reaching rural and dispersed populations this week
This week's evidence across five domains converges on one mechanism for extending admission-avoidance and home-based care to rural and deprived populations: redesigning how often, not how much, care reaches the patient.
Unread 7 minRural hospice patients in the US receive less intensive support and rely more on unpaid family caregiving than urban peers
A US research letter finds rural hospice patients are more likely to die in nursing homes, rely more heavily on unpaid family caregiving, and receive less intensive paid hospice support than urban patients.
Unread 1 minPlacebo-controlled trial finds no benefit from pilocarpine drops for dry mouth in frail and life-limited patients
A double-blind placebo-controlled trial in the Netherlands finds no significant difference in xerostomia symptoms between pilocarpine drops and placebo in frail or life-limited patients, though the trial was underpowered.
Unread 1 minPeople with opioid use disorder have equivalent palliative care needs but markedly worse access, scoping review finds
A scoping review of 21 studies covering roughly 681,000 participants finds people with opioid use disorder have palliative care needs equivalent to the general population but face fragmented care, unmet pain management and stigma-driven access barriers.
Unread 1 minOnly a quarter of international hospital-at-home admission-avoidance models use validated frailty measures, scoping review finds
A scoping review of 15 international Hospital-at-Home admission-avoidance models finds just four used a validated frailty measure, and communication practice between professionals, patients and carers varied widely.
Unread 1 minMultidisciplinary consensus sets out age-adjusted opioid prescribing standard for chronic pain in older adults
A multidisciplinary clinical consensus sets out age-adjusted opioid selection, dosing and route-of-administration standards for treating chronic pain safely in older adults.
Unread 1 minLarge English trial finds Open Dialogue crisis care cuts psychiatric admission and re-referral, despite no effect on relapse
The first large pragmatic English trial of Open Dialogue crisis care finds no difference in relapse rates but significantly lower psychiatric admission and re-referral, with better patient-rated recovery and satisfaction.
Unread 2 minImplementation capacity, not treatment efficacy, is the primary barrier to delivering high-intensity stroke rehabilitation, international roundtable concludes
A consensus of 16 international experts concludes that delivery and implementation capacity — not the underlying evidence for high-dose, high-intensity rehabilitation — is the primary barrier to delivering it, and names home- and community-based hybrid delivery as essential to closing the gap.
Unread 1 minEmergency-department-embedded geriatric assessment discharges most older patients home with hospital-at-home support rather than admission
A retrospective cohort study of over 8,000 emergency department attendances finds that comprehensive geriatric assessment embedded at first contact converts most encounters into home discharge with hospital-at-home support, rather than admission.
Unread 1 minCompetent initial assessment, not the number of quality indicators reported, predicts OPAT readmission risk, scoping review finds
A scoping review of 18 studies covering over 5,000 patients finds outpatient parenteral antimicrobial therapy readmission risk tracks whether a competent team member performs the initial patient assessment, not how many quality indicators a service reports.
Unread 1 minClinical Frailty Scale predicts outcomes in elderly heart failure patients, meta-analysis confirms
A meta-analysis finds the Clinical Frailty Scale is a validated prognostic tool specifically in elderly heart failure populations, though the finding should not be generalised to non-cardiac frailty pathways.
Unread 1 minBehaviour-change stewardship bundle nearly doubles appropriate-duration antibiotic prescribing in OPAT for urinary tract infection
A quasi-experimental stewardship intervention for patients receiving outpatient parenteral antibiotic therapy for urinary tract infection raised appropriate-duration prescribing from 44% to 83% and cut 90-day recurrence, without increasing readmissions.
Unread 1 minAdjunctive electrical stimulation speeds recovery of oral intake in acute stroke dysphagia, small trial finds
A randomised controlled trial finds adjunctive neuromuscular electrical stimulation produces significantly faster recovery of functional oral intake than swallowing therapy alone in acute and subacute post-stroke dysphagia.
Unread 1 minProtocol fidelity at the point of handover, not tool or drug choice, converts evidence into delivered benefit
This week's evidence answers a question earlier weeks left open: not whether earlier, community-facing care reduces avoidable hospital use, but what makes that model actually work — and a national dataset supplies the clearest quantified evidence yet that the workforce needed to deliver it is under strain.
Unread 9 minTelerehabilitation matches in-person stroke therapy for arm recovery only when dose is matched, systematic review finds
A systematic review of four randomised trials finds telerehabilitation is non-inferior to conventional in-person stroke rehabilitation for arm motor recovery only in the one trial that matched therapy dose between arms, with smaller, non-dose-matched trials showing mixed results.
Unread 1 minSix mechanisms determine whether mobile health improves home-based palliative care, realist review finds
A realist review of 126 studies identifies six mechanisms through which mobile health interventions improve home-based palliative care outcomes, and cautions that mHealth must be tailored to local infrastructure and technology competence rather than treated as a substitute for workforce capacity.
Unread 1 minRural palliative care access breaks down as a pathway and workforce problem, not simply a shortage of beds, systematic review finds
A mixed-methods systematic review of 34 studies finds rural palliative care access breaks down cumulatively across recognition, entry, reach and continuity stages, with distance, workforce shortages and weak specialist-generalist referral links driving the biggest barrier.
Unread 1 minPeople with ADHD have significantly poorer outcomes from standard NHS talking therapies, large cohort study finds
A retrospective cohort of over three million adults using NHS Talking Therapies in England finds people with diagnosed ADHD have significantly poorer recovery and higher deterioration rates than a matched comparison group, despite both groups improving overall.
Unread 2 minOPAT coordination consistency depends on a designated lead and checklist process, not on clinical suitability, US study finds
A mixed-methods US study across Veterans Affairs hospitals finds marked heterogeneity in outpatient parenteral antimicrobial therapy governance, with postdischarge coordination gaps concentrated at sites lacking a designated OPAT lead and checklist-based processes.
Unread 1 minNon-immersive exergames and remote exercise show the most consistent cognitive benefit for older adults, network meta-analysis finds
A Bayesian network meta-analysis of 51 randomised trials finds digital exercise interventions produce domain-specific cognitive benefits in older adults, with remote exercise and non-immersive exergames flagged as practical options for rural and resource-limited settings, though certainty of evidence is very low for most comparisons.
Unread 1 minMemory clinic patient volumes more than doubled over 25 years as referral thresholds broadened, national survey finds
A repeated national survey of Dutch memory clinics spanning 1998 to 2023 finds patient volume per clinic has more than doubled as the proportion of attendees diagnosed with dementia has fallen, with a third of clinics reporting infrastructure not yet ready for new disease-modifying treatment pathways.
Unread 1 minLandmark African trial finds early oral step-down non-inferior to prolonged IV antibiotics for severe childhood pneumonia
A large randomised trial across 13 hospitals in five sub-Saharan African countries finds stepping down to oral amoxicillin once children with severe community-acquired pneumonia improve, with total treatment as short as four to five days, is non-inferior to prolonged intravenous-only care.
Unread 1 minInpatient stroke rehabilitation is near-universal across Europe, but community and telerehabilitation provision lags well behind, survey finds
A cross-sectional survey of stroke rehabilitation services in 30 European countries finds inpatient provision is near-universal, but early supported discharge, community-based rehabilitation and telerehabilitation are markedly less consistently available.
Unread 1 minExercise improves short-term function in frail older adults but its effect on actual falls remains unproven, meta-analysis finds
A meta-analysis of 14 randomised trials finds short-term exercise improves gait speed and functional mobility in frail older adults, but falls-incidence data were too sparse to pool, leaving the link between functional gains and actual falls reduction unresolved.
Unread 1 minCommunity nursing time per palliative patient fell by two-thirds over a decade even as referrals rose, national data show
A decade-long national analysis of community nursing services in England finds referrals rose by roughly half while median time on caseload fell by two-thirds, with end-of-life care increasingly compressed into shorter, more out-of-hours contact.
Unread 1 min£343m expansion of community mental health centres will only work if staffed by psychologists, professional body warns
The UK government has committed £343m to up to 159 new NHS mental health facilities in England, but the British Psychological Society says the expansion will only succeed if centres are staffed with practitioner psychologists rather than built on new estate alone.
Unread 1 minEarlier, community-facing recognition consistently cuts avoidable hospital use — but the workforce needed to deliver it is under strain
This week's evidence reinforces a pattern now confirmed for over a month — earlier, community-facing recognition and disposition decisions cut avoidable hospital use more reliably than downstream specialist capacity — while a national workforce survey is a reminder that the generalist staff needed to deliver 'earlier' care are themselves under real strain.
Unread 7 minValidated triage tool for same-day emergency care outperforms existing scores in a deprived urban population
A retrospective diagnostic study of 152,877 emergency department attendances across three Birmingham hospitals derives and internally validates a new triage tool for identifying patients suitable for same-day emergency care, outperforming existing prediction scores.
Unread 2 minRetest effects in serial cognitive testing can mask a year or more of genuine age-related decline
A secondary analysis of a large US trial in 977 community-dwelling older adults finds that retest effects on repeat neuropsychological testing are large enough to offset roughly a year of expected age-related cognitive decline.
Unread 1 minProbenecid-boosted dosing offers a stability-compliant route to intravenous amoxicillin for community antibiotic therapy
A study backed by the BSAC OPAT Initiative finds citrate-buffered continuous-infusion amoxicillin fails UK stability criteria for community use, but probenecid-boosted intermittent or extended infusion regimens achieve adequate target attainment against clinically relevant organisms.
Unread 1 minNearly half of new psychoactive prescribing after intensive care discharge lacks a documented diagnosis
A US claims-database cohort of 7,898 mechanically ventilated ICU survivors finds 5.3% newly prescribed a psychoactive medication within 30 days of discharge, of which 43% lacked a documented supporting diagnosis, persisting out to two years.
Unread 1 minNational physiotherapy workforce survey signals a capacity warning against NICE-mandated rehabilitation intensity
The Chartered Society of Physiotherapy's quarterly member survey finds 79% of NHS physiotherapy staff report insufficient staffing for patient need, with recruitment freezes, deleted posts and whole-service cuts rising year on year.
Unread 1 minMulticomponent interventions outperform single reminders for raising advance care plan completion in primary care
A narrative review of 40 studies from 2000 to 2025 finds that multicomponent advance care planning interventions combining training, decision aids, systems prompts and dedicated consultations most consistently raise completion rates, while single-component reminders alone perform weaker.
Unread 1 minMajor Cochrane update on stroke dysphagia therapy adds 140 trials, reaffirms behavioural and electrical stimulation as first line
A major update of the Cochrane review on swallowing therapy for dysphagia in acute and subacute stroke, now spanning 181 randomised trials and 11,500 participants, finds moderate-certainty evidence for behavioural interventions and neuromuscular electrical stimulation.
Unread 1 minFive-year study finds post-stroke fatigue follows four distinct trajectories, not a uniform decline
A Norwegian multicentre cohort of 693 stroke patients followed for five years finds fatigue prevalence stable at 24-30% throughout, but latent trajectory modelling identifies four distinct fatigue subgroups requiring different follow-up approaches.
Unread 1 minEducation alone underperforms exercise for patellofemoral pain, but professional-led education matches it by medium term
A systematic review and meta-analysis of 20 randomised trials finds education alone underperforms exercise and multimodal physiotherapy on short-term pain and function for patellofemoral pain, though health-professional-delivered education performs comparably by medium-term follow-up.
Unread 1 minEarlier specialist palliative care contact halves in-hospital deaths in colorectal cancer, though most deaths still occur in hospital
A Finnish nationwide register cohort of 1,445 colorectal cancer patients finds that specialist palliative care contact more than 30 days before death is associated with fewer ED attendances, fewer hospitalisations and fewer in-hospital deaths than late or no specialist contact.
Unread 1 minBlood-based biomarkers materially change diagnostic confidence in memory clinic decision-making
A prospective study across three Netherlands academic memory clinics finds that disclosing a plasma biomarker panel at multidisciplinary team meetings increased diagnostic confidence in 46% of cases and revised the suspected diagnosis in 5%, using far less invasive testing than CSF or PET.
Unread 1 minAdvance care planning uptake in ALS has risen over a decade but remains held back by cognitive impairment
An Italian registry study of 1,219 people with ALS finds advance care planning discussions rose from roughly half to 62% over the past decade and were positively associated with palliative care activation and home death, but cognitive impairment reduced ACP uptake.
Unread 1 minAs home-based care scales, digital and carer-capacity gaps risk leaving the neediest patients behind
This week's evidence converges on a single reframing: as care shifts toward home-based and remote delivery, digital proficiency and carer capacity — not clinical eligibility — increasingly determine who benefits, while deliberate workforce deployment, not new treatment or technology, is this period's clearest lever for improving outcomes.
Unread 9 minScoping review catalogues 27 interventions to improve advance care planning among structurally vulnerable populations
A scoping review of 70 studies identifies 13 barriers, 13 facilitators and 27 interventions relevant to advance care planning among people experiencing housing instability, poverty, racialised identity, serious mental illness or substance use.
Unread 2 minSame-day emergency care shows markedly lower mortality than short-stay admission, but the authors caution this may reflect patient selection
A two-site English cohort study of 43,970 patients finds same-day emergency care associated with substantially lower 30-day mortality and reattendance than short-stay admission, though the authors caution the difference likely reflects lower-acuity patient selection rather than pathway superiority alone.
Unread 2 minRural and outer-regional areas set to carry double their population share of unmet palliative care need by 2045, Australian workforce model finds
A national Australian workforce-planning model projects that specialist palliative care supply will fail to keep pace with mortality-driven demand through 2045, with rural and outer-regional areas bearing a disproportionate share of unmet need.
Unread 2 minPreferred place of death tracks public understanding of palliative care, national Swedish survey finds
A national Swedish population survey finds preferences for place of end-of-life care and death correlate strongly with how well people understand palliative care, with misunderstanding — such as believing palliative care hastens death — associated with a preference for dying in hospital rather than at home.
Unread 2 minPhysiotherapy and occupational therapy staffing in day services slows functional decline over two years, Japanese cohort finds
A propensity-matched cohort of 1,908 older adults using adult day services in Japan finds those attending services staffed with physiotherapists and occupational therapists had significantly slower decline in activities of daily living over 24 months than those attending unstaffed equivalents.
Unread 2 minPhone-based frailty screening matches clinical scale accuracy without internet or in-person assessment
A South Korean validation study finds an automated interactive-voice-response frailty screening tool performs comparably to the Clinical Frailty Scale, offering a scalable, low-tech case-finding model for community-dwelling older adults.
Unread 2 minOnly a quarter of hospitalised patients in large US health system had a documented surrogate decision-maker, audit finds
A retrospective cohort of almost 980,000 US hospital encounters finds only 26.6% had documentation of a medical power of attorney, with documentation varying significantly by sex, marital status and diagnosis.
Unread 2 minHospital at Home policies risk leaving behind the dementia patients who could benefit most
A UK policy scoping review finds current Hospital at Home implementation criteria risk excluding people with dementia who lack digital proficiency or carer support, even though such schemes could otherwise reduce inequalities for this group.
Unread 2 minDay-hospital long-acting antibiotic pathways show strong real-world clinical success, though the economic case remains modelled rather than proven
A nine-centre Italian retrospective study of 160 patients treated with long-acting lipoglycopeptides in a day-hospital setting reports an 86.8% clinical success rate and a low adverse-event rate, with modelled cost savings the authors describe as hypothesis-generating rather than proven.
Unread 2 minComponent-level meta-analysis finds social support and behavioural activation outperform specialist techniques in non-specialist-delivered mental health care
A Bayesian component network meta-analysis of individual participant data from 30 trials finds strengthening social support, behavioural activation and problem management drive most of the benefit in non-specialist-delivered psychosocial interventions, while specialist techniques such as cognitive reframing showed detrimental effects when delivered by non-specialists.
Unread 2 minAdding primary-care rehabilitation to device-aided Parkinson's therapy improves motor-skill maintenance, small RCT finds
A randomised controlled trial finds that adding three months of tailored primary-care physiotherapy and occupational therapy rehabilitation to device-aided Parkinson's disease therapy improves motor-skill maintenance and perceived health at 6 and 12 months compared with device-aided therapy alone.
Unread 2 minRecord A&E waits for older patients and a fourth week of evidence converge on the same fix: earlier identification, not new treatment
National data showing the oldest patients face the longest emergency department waits converges with a fourth consecutive week of clinical evidence pointing to early identification as the dominant lever, while several of this week's largest measured gains came from low-cost structured protocols rather than new technology.
Unread 10 minReproducible case-finding rule identifies frequent-attender frail patients for proactive assessment
Baseline analysis of a Swedish randomised trial shows a simple, reproducible case-finding rule can identify multimorbid, frequent emergency attenders as a target group for proactive community assessment.
Unread 2 minNearly a third of older adults with severe breathlessness are lonely, national English cohort finds
A nationally representative English cohort finds loneliness affects almost a third of adults aged 50 and over with severe breathlessness, with deprivation, living alone and depressive symptoms the strongest predictors.
Unread 1 minLargely unsupervised balance training nearly halves fall rate in community-dwelling older adults, trial finds
A multicentre randomised trial finds 12 weeks of self-administered dual-task balance training, with only a sixth of sessions supervised, nearly halved the fall rate compared with self-administered single-task training.
Unread 1 minInternational researchers propose standardised outcome to fix inconsistent cognitive-outcome reporting after stroke and cardiac care
A new position paper proposes a standardised composite outcome, MACE-Cog, to address widespread inconsistency and incompleteness in how cognitive decline is measured and reported after stroke and cardiac interventions.
Unread 2 minEthnic minority patients more likely to enter palliative care via specialist referral, national cohort study finds
A national retrospective cohort of over 200,000 deceased patients in England finds no significant ethnic disparity in overall primary-care palliative identification, but ethnic minority patients were more likely to enter via specialist referral, with differing survival by ethnic group.
Unread 2 minEarlier specialist palliative contact roughly halves end-of-life hospitalisation in pancreatic cancer, national Finnish cohort finds
A nationwide Finnish register study finds patients with pancreatic cancer who had specialist palliative care contact more than 30 days before death were hospitalised far less often, and far more likely to receive care at home, in their final month of life.
Unread 2 minBrief GP-delivered psychological intervention improves quality of life a year after ICU discharge, trial finds
A secondary analysis of a randomised trial finds a brief GP-delivered intervention for ICU survivors with PTSD symptoms produced a delayed but clinically meaningful quality-of-life improvement at 12 months.
Unread 1 minAssessment at first contact, not treatment availability, is this week's dominant lever across frailty, psychology and palliative care
This week's evidence shows that assessment and identification at first contact, not treatment availability, determines whether frail, cognitively impaired and dying patients reach the right pathway, while national data confirms the capacity cost of getting it wrong.
Unread 10 minVocational rehabilitation trial finds no benefit on work limitations, and mixed results on retention and cost
A UK multicentre RCT finds occupational-therapy-delivered job-retention vocational rehabilitation shows no benefit over self-help advice on work limitations at 12 months, and was not cost-effective from an NHS perspective.
Unread 1 minSystematic review sets out what makes advance care planning work in nursing homes
A PROSPERO-registered systematic review identifies the structural and process determinants that distinguish nursing homes that implement advance care planning well from those that do not.
Unread 1 minSystematic review finds telerehabilitation a comparable alternative to centre-based cardiac rehabilitation after acute coronary syndrome
A systematic review of 12 randomised trials finds app- and web-based telerehabilitation performs comparably to centre-based cardiac rehabilitation after acute coronary syndrome or revascularisation, with gains in adherence and quality of life.
Unread 1 minPICCs carry far fewer complications than midline catheters in outpatient antimicrobial therapy, US cohort finds
A US retrospective cohort of over 1,100 outpatient parenteral antimicrobial therapy patients finds midline catheters carry more than three times the complication risk of peripherally inserted central catheters.
Unread 1 minParamedic-delivered end-of-life protocol linked to far fewer emergency visits and more home deaths, Finnish cohort finds
A Finnish retrospective cohort finds cancer patients enrolled in a structured, paramedic-delivered end-of-life protocol spent more time at home and died at home six times more often than those not enrolled.
Unread 1 minNearly half of NHS hospital physiotherapists report losing rehabilitation space, survey finds
A Chartered Society of Physiotherapy member survey finds 49% of NHS hospital physiotherapists report losing rehabilitation space, with members linking the loss to rising waiting lists and worsening patient disability.
Unread 1 minMulticentre cohort identifies a distinct vulnerability subgroup after home return from severe brain injury
A large multicentre cohort finds 17% of adults are in a distinct 'multidomain vulnerability' group a year after returning home following severe traumatic brain injury, predicted by identifiable risk factors.
Unread 1 minMeta-analysis finds remote cardiac rehabilitation matches or exceeds centre-based care for heart failure patients
A meta-analysis of eight randomised trials finds mobile-health-supported remote or hybrid cardiac rehabilitation performs as well as, or better than, centre-based rehabilitation on exercise capacity in heart failure, though certainty is low to moderate.
Unread 1 minFeasibility trial tests giving physiotherapists individual feedback to standardise MSK referral decisions
A UK feasibility cluster trial tests whether a dashboard giving First Contact Physiotherapists individualised feedback on their own referral patterns can reduce unwarranted variation in musculoskeletal care decisions.
Unread 1 minCrisis-response models for older people need common commissioning design principles, review finds
A critical review maps five national crisis-response models for older people onto shared commissioning design principles, offering a common benchmark for services usually assessed in isolation.
Unread 1 minBrief six-domain cognitive screen validated for use in acute stroke, UK study finds
A UK validation study finds a brief, 9-to-15-minute cognitive screen performs consistently across left- and right-hemisphere stroke, offering an option where full neuropsychological assessment is not feasible.
Unread 1 minA reablement-based discharge model loses its evidence base, as capacity emerges as the binding constraint on frailty and palliative care
A systematic review and meta-analysis finds weak evidence behind reablement-based discharge-to-assess — the model much of the NHS relies on — as this week's wider evidence converges on workforce capacity, documentation continuity and referral screening as the binding constraint on better frailty, palliative and rehabilitation care.
Unread 9 minWorld Stroke Organisation issues new scientific statement on vascular cognitive impairment
An international expert statement sets out new diagnostic criteria and management guidance for vascular cognitive impairment, including its overlap with post-stroke cognitive decline.
Unread 1 minTelehome palliative care improves access and continuity, but success hinges on digital readiness, review finds
An integrative review of 33 studies finds telehealth-supported home palliative care improves access and symptom-management continuity, but success depends on digital literacy, caregiver burden and organisational readiness.
Unread 1 minSpecialist screening before OPAT referral avoided almost 14,000 inpatient days over three years, audit finds
A three-year audit of an outpatient parenteral antimicrobial therapy referral pathway finds nearly a third of referrals were not taken onto the service after specialist screening, avoiding an estimated 13,909 inpatient or IV-therapy days.
Unread 1 minReablement-based home rehabilitation shows weak evidence of benefit, meta-analysis finds
A GRADE-assessed systematic review and meta-analysis of 27 trials finds reablement-based home rehabilitation has low-to-very-low-certainty evidence of improving daily function, while structured exercise-based rehabilitation does show benefit.
Unread 1 minQualifying care-home nursing staff in palliative care improves specialist contact and pain management, trial finds
A German cluster randomised study finds a 40-hour palliative qualification course for care-home nursing staff increases specialist outpatient contact and improves pain-management follow-through.
Unread 1 minPharmacist involvement in OPAT teams cuts prescribing errors, meta-analysis finds
A systematic review and meta-analysis finds pharmacist involvement in OPAT multidisciplinary teams improves monitoring adherence and reduces prescribing errors, though impact on readmissions remains inconsistent.
Unread 1 minMeta-analysis confirms exercise-based rehabilitation eases depression in rheumatoid arthritis
A meta-analysis of 15 randomised trials finds structured exercise reduces depressive symptoms in rheumatoid arthritis with moderate certainty.
Unread 1 minInternet-delivered psychological therapy improves quality of life in persistent physical symptoms, trial finds
A randomised trial finds internet-delivered acceptance and commitment therapy improves health-related quality of life at nine months for people with persistent physical symptoms.
Unread 1 minIndividualised exercise programme improves balance and postural control in older adults, trial finds
A randomised trial finds a multisegmental, individually tailored exercise programme produces large improvements in balance and postural sway compared with an education-video control.
Unread 1 minHome deaths best match patient preference, but specialist units deliver better pain control, Canadian cohort finds
A Canadian decedent-proxy cohort study finds home deaths most closely match preferred place of death, while palliative care units and hospices deliver better pain control, with regional policy strongly predicting access.
Unread 1 minGeriatric rehabilitation lacks a common core, systematic review finds
A systematic review of 36 studies finds such variation in terminology, teams and assessment tools that no single study could describe a full geriatric rehabilitation pathway holistically.
Unread 1 minA fifth of sepsis patients develop new-onset frailty by discharge, registry study finds
A Korean multicentre registry finds 22.9% of previously non-frail sepsis patients develop new-onset frailty by discharge, with fewer than half of newly-frail survivors discharged home.
Unread 1 minStructural risk, not clinical need, is driving outcomes across frailty and end-of-life care
This week's evidence and national policy commentary converge: identifying who is structurally at risk, and redesigning access around that, is where the largest near-term gains in value-added time sit — not new clinical treatment.
Unread 6 minNewer composite frailty tools outperform guideline-endorsed scales, study finds
A large Swedish cohort study finds newer composite frailty indices predict institutionalisation, mortality and hospitalisation more accurately than commonly used guideline tools.
Unread 1 min