Scoping review of outcomes reported in studies with older adults in the Emergency Department

Abstract

Background The number of older adult Emergency Department (ED) attendances is rising in line with population ageing. These ED visits are associated with adverse outcomes. Consequently, intervention studies with older adults in the ED aiming to mitigate adverse outcomes are increasing. However, there is currently no agreement on what outcomes to measure in these studies. This outcome heterogeneity has negative implications for synthesising evidence and for policy implications. To address this issue, we plan to develop a Core Outcome Set (COS) for use in studies with older adults in the ED setting. The first step in this process is to generate a long list of potential outcomes to include in the COS via a scoping review. Methods A scoping review was conducted in accordance with the Joanna Briggs Institute methodological guidance and reported with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). An international trial register and 3 electronic databases were searched to locate experimental studies that recruited a population of older adults (aged 65yrs+) or in the ED. Searches and screening were completed independently by two researchers. Data was extracted using a custom data extraction template, the study design, outcomes measured, outcome tools, and measurement timepoints were recorded. Results Over 23,000 papers were screened with a full text review of 363 papers and a final inclusion of 106 papers. Outcomes were split into primary and secondary with a total of 217 in total reported across included studies (93 primary and 124 secondary outcomes). The modified Dodd taxonomy for Core Outcome Sets was utilised with 38 outcome domains used to categorise the outcomes reported. Conclusion This scoping review has highlighted the large variety of outcomes. Mapping these outcomes will inform the development of a Core Outcome Set which will have the potential to enhance future trials with this population.