Future of an ageing population evidence review; Developing medical fitness and wellbeing environments to maintain health and wellbeing over the lifecourse.

摘要

Background and methodsudThis report is derived from a review of the research evidence on physical activity interventionsudand initiatives, interventions to support self-management/ self-care of long-term conditions anduddigitally enabled care services and technologies. The aim was to use existing evidence toudenvision future services and associated infrastructure.udThe Evidence Review involved scoping the literature for topics researched and to determine theudnature of that research. Rapid-scoping review methods were applied to trusted sources, andudsearches for specific key texts were conducted. A separate search was conducted to identifyudliterature relevant to each domain. A narrative was then produced from the review findings.udReview findingsudThe evidence base for physical activity interventions is growing. There has been significantudrecent investment in the development and evaluation of interventions to promote activity andudreduce sedentary behaviour at the individual, community and population levels. The evidence toudlink higher levels of physical activity to positive health outcomes and disease prevention isudconvincing, both in ‘well’ populations and in those with long-term health conditions.udSelf-management interventions are heterogeneous in nature but common elements exist acrossudthe majority of them. The consensus in the literature is that self-management will becomeudincreasingly important due to unsustainable demands upon services. Evaluation of selfmanagementudinterventions reveals a small but varying effect across a wide range of outcomes.udHowever, little is known about the mechanisms by which these interventions work and howudthese might vary across differing conditions and populations.udTechnology is being increasingly used to support service delivery in a wide range of contexts,udand for the delivery of a variety of interventions including fitness and self-management. There isudstrong evidence supporting the use of technology for remote monitoring of people with longtermudconditions, but further research is required.udImplicationsudDigital applications are already altering established patterns of service delivery. The findingsudpresented here reveal varying results of efficacy which do not accord with the optimistic futureuddescribed in various envisaging reports. Research has yet to consider unwanted andudunforeseen effects of moving towards technology-enabled services. It is also important toudconsider how to effectively harness new health data emerging from the use of eHealth systems,udtechnology-enabled services and health-tracking devices.udThere is an ongoing requirement to evaluate new technologies and technology-enabledudservices in ways that provide both timely and robust answers, particularly as technologyuddevelopment is a continually moving target. These considerations are discussed in this report.