NEW

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.

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.

A large Swedish cohort study finds newer composite frailty indices predict institutionalisation, mortality and hospitalisation more accurately than commonly used guideline tools.

A single-centre implementation study of therapeutic drug monitoring-guided dalbavancin dosing achieved a full treatment course in three administration visits, with high target attainment and low discontinuation.

A UK cohort study of people with dementia and their carers finds advance care planning uptake tracks carer education and resourcing more closely than clinical need.

The HERO multicentre randomised controlled trial (740 participants, 15 UK sites) found a 24-week therapist-delivered home exercise programme after discharge produced no improvement in 12-month physical health-related quality of life for older people with frailty, at an incremental cost of £1,401 per participant; the authors recommend against routine commissioning.

A retrospective NHS audit found patients coded onto the Gold Standards Framework were far more likely to have a documented advance care plan and to die outside hospital than uncoded patients.

A UK propensity-matched cohort study found pre-existing multiple long-term conditions cut the odds of full recovery one year after COVID-19 hospitalisation by 34%, driven mainly by pre-existing respiratory disease.

This week's evidence base converges on a single message: structured identification and coding — not new clinical intervention — is what moved outcomes across frailty, psychology and palliative care, with a well-powered meta-analysis giving a clear steer on community rehabilitation design.

A meta-analysis of 27 randomised controlled trials in community-dwelling older adults found activity- and exercise-based home rehabilitation improved daily-living function and physical performance, while reablement-based approaches showed no significant effect.