Thirty-two clinical trials (16,389 participants) were included in the review: 25 randomised controlled trials and seven non-randomised studies. Trials either used in-hospital geriatric assessment during the hospital stay and comprehensive discharge planning or evaluated geriatric assessments with home-based follow-up. Fourteen trials fulfilled most or all SIGN quality criteria and 13 trials fulfilled some quality criteria. Five studies fulfilled few or no criteria. Follow-up ranged from one month to 18 months.
In-hospital geriatric evaluation and discharge management (17 trials, 8,668 participants): Three studies found significant benefits of the interventions in terms of reduced admissions. In one study there were benefits only for one month post-discharge with no differences observed between the intervention and usual care at two months follow-up. A negative effect of the interventions was found in one study. There no differences were observed in the remaining 13 studies.
Geriatric assessment with home follow-up (15 trials, 7,701 participants): Seven trials reported significant benefits of the interventions on readmissions at follow-up. Five studies found some benefits of the intervention at follow-up times of 30 days to six months post-discharge. Another trial found no difference between groups at three months follow-up but benefits of the intervention were observed at 18 months. One study that involved a home-based medication review found more admissions to hospital in the intervention group. The remaining studies found no differences between groups on readmission outcomes.