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Effectiveness of dyadic interventions in improving outcomes for adults with multiple long-term conditions or frailty and their informal carers: a systematic review

In brief

Dyadic programs modestly lower emergency visits and hospital readmissions for frail seniors

A review of eight randomized trials involving 3,630 older adults with multiple chronic conditions or frailty and their informal carers found that joint caregiver-patient interventions reduced emergency department use, readmissions, and functional decline in patients, and eased caregiver burden. However, these programs did not improve quality of life or mental health, and the evidence remains low certainty.

Journal
The lancet. Healthy longevity (Q1)
Published
6 August 2026
Study design
Systematic review / meta-analysis of RCTs
Evidence level
Level 1, High (CEBM 1a)
Authors
Stella Arakelyan, Daniela Lillekroken, Mozhu Ding, Michaela Gilarova, Atul Anand, Maria Kristiansen, et al.
PMID
42561981
DOI
10.1016/j.lanhl.2026.100875

Why clinicians should know about it

Abstract

Dyadic interventions targeting carer-care recipient pairs are effective in improving psychosocial outcomes in single diseases, but whether similar interventions are beneficial in the context of multiple long-term conditions or frailty remains unclear. In this systematic review, we synthesised evidence on the effectiveness of community dyadic interventions in improving outcomes for adults aged 55 years or older with multiple long-term conditions or frailty, or both, and their informal carers. We searched six databases for experimental and quasi-experimental studies published from Jan 1, 2010 to Sept 25, 2025. Of the 5284 records screened, eight randomised controlled trials (seven with a moderate risk of bias) reporting on seven unique trials and 3630 dyads were included. Dyadic interventions had some beneficial effects on reducing emergency care visits, hospital readmissions, and functional decline in care recipients, and on reducing caregiving burden in carers (low certainty of evidence), but showed little or no effect on quality of life (low certainty of evidence) or mental health outcomes (predominantly very low certainty of evidence) in both care recipients and carers. No trial evaluated effects on social aspects of care or mortality.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.