Behaviour change techniques in personalised care planning for older people: a systematic review

Ahmed, Sadia; Heaven, Anne; Lawton, Rebecca; Rawlings, Gregg; Sloan, Claire; Clegg, Andrew

BACKGROUND: Personalised care planning (PCP) interventions have the potential to provide better outcomes for older people and are a key focus in primary care practice. Behaviour change techniques (BCTs) can maximise effectiveness of such interventions, but it is uncertain which BCTs are most appropriate in PCP for older adults. AIM: To identify BCTs used in successful PCP interventions for older people aged ≥65 years. DESIGN AND SETTING: Systematic review. METHOD: The authors searched 12 databases from date of inception to 30 September 2017. They identified randomised controlled trials (RCTs) of interventions involving participants aged ≥65 years, and contextually related to PCP. Five areas of risk of bias were assessed. The Michie et al, BCT taxonomy was used for coding. RESULTS: Twenty-three RCTs involving 6489 participants (average age 74 years) described PCP interventions targeting the general older adult population and older people with specific long-term conditions (for example, heart disease, diabetes, stroke). Just over half of the studies were deemed to be at a low risk of bias. Eleven ‘promising’ BCTs were identified in five trials reporting significant improvements in quality of life (QoL). Six BCTs were reported in all five of these trials: ‘goal setting’, ‘action planning’, ‘problem solving’, ‘social support’, ‘instructions on how to perform a behaviour’, and ‘information on health consequences’. Modes of delivery varied. CONCLUSION: Future PCP interventions to improve QoL for people aged ≥65 years may benefit from focusing on six specific BCTs. Better reporting of BCTs would enhance future design and implementation of such interventions.