Defining the Components of a Nurse Practitioner-Led Home Visit Intervention for Frail Patients: An International Delphi Consensus Study
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Purpose
Aging in place has become a central objective of health and social policies across the world, yet frailty and multimorbidity significantly undermine individuals’ capacity to remain safely at home. The aim was to identify the potential components of a home visit intervention led by nurse practitioners for frail populations.
Design
A consensus study using a two-round Delphi method
Methods
A two-round Delphi study was conducted in summer 2024 with 15 experts from four French-speaking countries (Quebec–Canada, Switzerland, Belgium, and France). The questionnaire was based on documented needs of frail patients and their caregivers.
Results
Experts identified the target population as older adults needing home care, people with physical or cognitive impairments, those requiring end-of-life care, and individuals experiencing difficulties remaining at home. Eligibility criteria included frailty, multiple chronic conditions, mobility issues, social isolation, and low socio-economic status. The nurse practitioner’s role should include clinical assessment, treatment adjustments, care coordination, therapeutic education, support for patients and families, and promotion of self-care. Nurse practitioners may also serve as a reference for other healthcare professionals. Home visits should be initiated by healthcare providers, patients, or family members, with visit frequency and duration adapted to individual needs.
Conclusions
This study identified components of a nurse practitioner-led home visit intervention for frail individuals that achieved expert consensus, while highlighting areas where consensus was not reached.
Clinical Relevance
These findings will inform the development and future evaluation of such an intervention in real-world settings.
Highlights
What is already known
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Frail people living at home have complex clinical, functional, and social needs.
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Home visit interventions may improve access to care for vulnerable populations.
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The content of nurse practitioner-led home visits is not clearly defined.
What this paper adds
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This Delphi study identifies eligibility criteria for nurse practitioner-led home visits, including frailty, multimorbidity, mobility issues, social isolation, and low socioeconomic status.
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It defines key nurse practitioner roles during home visits, such as clinical assessment, treatment adjustment, care coordination, and support for patients and caregivers.
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It specifies modalities of nurse practitioner home visits, including referral pathways, visit duration, and adaptation to patients’ evolving needs.
