The prevalence of non-pharmacological interventions in older homecare recipients: an overview from six European countries

Purpose
Non-pharmacological interventions (NPIs) play an important role in the management of older people receiving homecare. However, little is known about how often specific NPIs are being used and to what extent usage varies between countries. The aim of the current study was to investigate the prevalence of NPIs in older homecare recipients in six European countries.

Methods
This is a cross-sectional study of older homecare recipients (65+) using baseline data from the longitudinal cohort study ‘Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of community care’ (IBenC). The analyzed NPIs are based on the interRAI Home Care instrument, a comprehensive geriatric assessment instrument. The prevalence of 24 NPIs was analyzed in Belgium, Germany, Finland, Iceland, Italy and the Netherlands. NPIs from seven groups were considered: psychosocial interventions, physical activity, regular care interventions, special therapies, preventive measures, special aids and environmental interventions.

Results
A total of 2884 homecare recipients were included. The mean age at baseline was 82.9 years and of all participants, 66.9% were female. The intervention with the highest prevalence in the study sample was ‘emergency assistance available’ (74%). Two other highly prevalent interventions were ‘physical activity’ (69%) and ‘home nurse’ (62%). Large differences between countries in the use of NPIs were observed and included, for example, ‘going outside’ (range 7–82%), ‘home health aids’ (range 12–93%), and ‘physician visit’ (range 24–94%).

Conclusions
The use of NPIs varied considerably between homecare users in different European countries. It is important to better understand the barriers and facilitators of use of these potentially beneficial interventions in order to design successful uptake strategies.