Mapping long-term care needs in person-centred interventions for older people with multimorbidity: a WHO framework-guided secondary analysis

Abstract

Background/Objectives: Person-centred psychosocial and rehabilitation interventions are increasingly relevant in long-term care (LTC) for older people with multimorbidity. Existing classifications describe the technical nature of these interventions rather than the LTC needs addressed by their delivered components. This study aimed to map delivered or reported components from a published parent review onto the World Health Organization long-term care framework. Methods: We conducted a framework-guided secondary analysis of 18 randomised controlled trials, including 9132 participants, from the parent review. Trials were conducted in LTC or settings relevant to LTC. Components were deductively mapped at study level to five framework domains: health care needs, palliative care needs, social care and support needs, person-centred integrated care, and education and training. Mapping followed predefined operational rules, a codebook, and a decision log. Planned-only components were excluded. Results were synthesised descriptively, without reassessing intervention efficacy. Results: Health care needs were identified in 17 of 18 trials, social care and support needs in 14, person-centred integrated care in all 18, and education and training in 17. Palliative care needs were less frequently represented, appearing in four trials. Psychosocial and Rehabilitation components were interpreted as mainly representing the technical-therapeutic core of interventions, while Complementary components were interpreted as supporting the operational infrastructure of care, including assessment, planning, coordination, monitoring, referral, training, documentation, and continuity. Conclusions: This framework-guided secondary analysis suggests broad but uneven coverage of WHO long-term care domains across the included trials. Future trials should more explicitly align targeted needs, delivered components, and outcome assessment, including social, caregiver, palliative, continuity, and person-centred care experience outcomes.