Implementing integrated care for older adults in primary health care: A systematic scoping review.

BACKGROUND As populations age worldwide, primary health care systems face increasing challenges in addressing the complex health and social needs of older adults. Integrated care offers a promising approach to promote healthy ageing by providing coordinated, person-centred services across care settings. However, there is a lack of synthesised evidence on integrated care implementation in primary health care, which limits our understanding of its full potential.

OBJECTIVE To map how integrated care for older adults has been implemented in primary health care worldwide, identify the most scalable components, and highlight practice and policy implications for strengthening primary health care systems.

METHODS We conducted a scoping review to synthesise evidence on the implementation and outcomes of integrated care interventions for older adults in primary health care settings. We systematically searched PubMed, Embase, and CINAHL for studies published in the past ten years. Eligible studies included interventional designs targeting individuals aged ≥60 years and implemented integrated care as defined by the WHO. Data were extracted and analysed using narrative synthesis and frequency analysis.

RESULTS A total of 181 studies across 26 countries were included. Most interventions were community- or primary health care-based, multidisciplinary (91%), and involved cross-sectoral integration (47%). Core components included care coordination/personalised care planning (67%), physical activity (40%), health education (38%), and psychosocial support (29%). Overall, 88% of studies reported positive outcomes, most often at the patient level. However, implementation outcomes such as acceptability (21%), feasibility (19%), and fidelity (9%) were inconsistently assessed. Evidence was dominated by high-income settings, with limited representation from low- and middle-income countries.

CONCLUSIONS Integrated care in primary health care shows broad potential to improve outcomes for older adults, particularly when built around care coordination, team-based delivery, and person-centred planning. Scalable models are those that use existing primary health care resources, integrate community health workers, and employ low-cost digital tools. Yet critical gaps remain in implementation fidelity, sustainability, and equity, especially in resource-limited settings. Embedding integrated care within quality improvement cycles can accelerate adoption and adaptation, offering a pathway for primary health care systems worldwide to promote healthy ageing.