The effect of psychosocial and healthcare interventions on reducing hospitalisation in people with dementia: an umbrella review

People with dementia are at increased risk of hospitalization compared to individuals without dementia, yet the efficacy of psychosocial and healthcare interventions in reducing hospitalization is unclear. We conducted an umbrella review examining the effects of psychosocial and healthcare interventions compared to controls on reducing hospitalization in people with dementia. We included 25 systematic reviews comprising 77 unique studies totaling 1,483,077 participants. There was high-certainty evidence that case management and exercise programs had no effect on reducing hospitalization, low-certainty evidence that advance care planning reduced hospital admissions, and moderate-certainty evidence that clinical pharmacists in multidisciplinary teams (MDTs) reduced medication-related hospital re-admissions. The evidence for psychosocial and healthcare interventions in reducing hospitalization in dementia is insufficient to make strong positive recommendations, but there are indications that advance care planning and clinical pharmacists in MDTs may be beneficial. High-quality randomized controlled trials are required to establish more confident clinical recommendations.