Self-management support interventions for socioeconomically disadvantaged older adults with chronic conditions: A systematic review.

Abstract

To identify and describe the theories, components, and effectiveness of self-management support interventions for socially disadvantaged older adults (≥60 years) with chronic conditions and multimorbidity. Six electronic databases were searched in November 2023. Randomised controlled trials (RCTs) focused on self-management support interventions for socioeconomically disadvantaged community-dwelling older adults with chronic conditions and multimorbidity were included. Data extraction was guided by the Practical Reviews in Self-Management Support taxonomy, and study appraisal used the Revised Cochrane Risk of Bias tool. A critical narrative synthesis was conducted. Eighteen trials (N = 6269) were included. Interventions varied in their theoretical foundations, components, and delivery methods, showing promise in improving health-related quality of life, mental health, self-management behaviours, and self-efficacy outcomes, while reducing healthcare utilisation. Tailored, multi-component interventions may be effective in improving outcomes for socioeconomically disadvantaged older adults. Future research should prioritise the development of accessible, culturally appropriate self-management support interventions tailored to disadvantaged populations. These interventions should be evaluated in primary care and community settings for their effectiveness, scalability, and sustainability. Healthcare providers should integrate multi-component, theory-based support into routine care. Policymakers should create flexible funding and policies to support long-term implementation, addressing health disparities in disadvantaged communities.