Goal-setting in geriatric rehabilitation: a systematic review and meta-analysis.
Ewout B Smit, Hylco Bouwstra, Cees Mpm Hertogh and 2 others
PMID 30537854WHAT IT FOUND
Goal-setting did not improve physical functioning, quality of life, or reduce rehabilitation duration in older adults compared to usual care.
The evidence was low quality, and usual care often already included some form of goal-setting, making it hard to see a benefit from standardized methods.
Key findings
01The meta-analysis of seven studies showed no significant difference in physical functioning between goal-setting and care as usual.
02There was no statistically significant difference in quality of life or duration of rehabilitation between the groups.
03The overall risk of bias in the included studies was considerable, primarily due to lack of blinding and baseline imbalances.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The evidence quality is low due to high risk of bias in included studies, particularly lack of blinding and baseline imbalances. Care as usual often already included some form of goal-setting, making it difficult to isolate the effect of the standardized intervention. The review included a heterogeneous group of patients with varying levels of comorbidity and cognitive function, and most studies did not report on these factors. The confidence intervals for quality of life and duration of rehabilitation were wide, so a clinically relevant effect in either direction could not be ruled out. None of the included studies performed a process evaluation to assess adherence to the goal-setting protocol.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research.
The easy way to misread this
Do not conclude that goal-setting is useless. The study compared standardized goal-setting protocols to usual care, which often already included informal goal-setting. The null result suggests that adding a formal standardized method to existing care may not improve outcomes, not that involving patients in their care is ineffective.