NEW

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

An international expert statement sets out new diagnostic criteria and management guidance for vascular cognitive impairment, including its overlap with post-stroke cognitive decline.

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.

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.

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.

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.

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.

A meta-analysis of 15 randomised trials finds structured exercise reduces depressive symptoms in rheumatoid arthritis with moderate certainty.

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.

A randomised trial finds a multisegmental, individually tailored exercise programme produces large improvements in balance and postural sway compared with an education-video control.

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.

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.

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.

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.