Programme RL session Ageing and Long-Term Care

Title: Better care for older persons without evidence base? An expensive illusion!

Proving high quality long-term care for older persons is challenging. The complexity of long-term care has increased tremendously over the last decades, not only caused by aggregated care needs of patients but also through technological and related health care innovations. Despite the increasing complexity of care, the number of well-trained and educated staff is decreasing. Simultaneously, there is a strong need for development and implementation of technology and evidence-based practice. A solid interaction between clinical practice, education and scientific research is badly warranted as a tradition of scientific research in long term care is lacking.

Given the limited resources (personnel, time, money) for care for older persons, and more general for care in its broadest sense, the implementation and (dis)continuation of interventions should be based on empirical evidence for their effects on outcomes of importance according to clients and other stakeholders. Such evidence can only be based on establishing causal relations between factors or interventions and outcomes. Causal relations in turn are best established by strong research designs, but practical and sometimes ethical considerations call for consideration of a broader range of designs, and a well-informed choice of the strongest design that is feasible.

In this session we will first briefly discuss requirements for causal inference (counterfactuals, no hidden confounders, cause precedes effect) and a range of research designs with their pros and cons. Subsequently, frequently encountered research situations in long-term care will be presented by (junior) researchers and discussed with respect to their suitability for causal inference and possible design improvements. Finally, the role of clients, family and other stakeholders in establishing evidence for the effectiveness of interventions will be discussed.



14.15     Opening and general announcements ALTC
  Ruud Kempen and Jan Hamers 
14.30 Better care for older persons without evidence base? An expensive illusion!
  Session chaired by Michel Bleijlevens
  14.35 Introduction to research designs and causality
  Gerard van Breukelen
  14.55 Discussion cases from the ALTC Research Program
  2 to 3 pitches of methodology and research design by ALTC researchers
  15.45 What is the role of clients in research?
  Silke Metzelthin 
  16.00 Discussion 
16.15 Closure