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

Abstract

Background and methods This report is derived from a review of the research evidence on physical activity interventions and initiatives, interventions to support self-management/ self-care of long-term conditions and digitally enabled care services and technologies. The aim was to use existing evidence to envision future services and associated infrastructure. The Evidence Review involved scoping the literature for topics researched and to determine the nature of that research. Rapid-scoping review methods were applied to trusted sources, and searches for specific key texts were conducted. A separate search was conducted to identify literature relevant to each domain. A narrative was then produced from the review findings. Review findings The evidence base for physical activity interventions is growing. There has been significant recent investment in the development and evaluation of interventions to promote activity and reduce sedentary behaviour at the individual, community and population levels. The evidence to link higher levels of physical activity to positive health outcomes and disease prevention is convincing, both in ‘well’ populations and in those with long-term health conditions. Self-management interventions are heterogeneous in nature but common elements exist across the majority of them. The consensus in the literature is that self-management will become increasingly important due to unsustainable demands upon services. Evaluation of selfmanagement interventions reveals a small but varying effect across a wide range of outcomes. However, little is known about the mechanisms by which these interventions work and how these might vary across differing conditions and populations. Technology is being increasingly used to support service delivery in a wide range of contexts, and for the delivery of a variety of interventions including fitness and self-management. There is strong evidence supporting the use of technology for remote monitoring of people with longterm conditions, but further research is required. Implications Digital applications are already altering established patterns of service delivery. The findings presented here reveal varying results of efficacy which do not accord with the optimistic future described in various envisaging reports. Research has yet to consider unwanted and unforeseen effects of moving towards technology-enabled services. It is also important to consider how to effectively harness new health data emerging from the use of eHealth systems, technology-enabled services and health-tracking devices. There is an ongoing requirement to evaluate new technologies and technology-enabled services in ways that provide both timely and robust answers, particularly as technology development is a continually moving target. These considerations are discussed in this report.