Key Message

• This Horizon Scan summarizes the available information regarding hearing restorative devices for improving cognition or delaying disease progression for people living with dementia.
• Hearing loss is 1 of the largest modifiable risk factors for dementia.
• Evidence regarding the effectiveness of hearing devices to improve cognition in people living with dementia is still evolving. However, in individuals without dementia, managing hearing loss may prevent cognitive decline in the long term.
• Early evidence suggests that hearing aids may be a cost-effective intervention for preventing dementia in the long term.
• Barriers to access such as high out-of-pocket costs, equitable access to health care, and low utilization even in the general population are issues to consider. If managing hearing loss with hearing restorative devices indeed prevents cognitive decline, if they are accessible only to those with the financial means to pay high out-of-pocket costs, this could exacerbate systemic health inequities.

Key Message

For older adults with incontinence in a personal care home setting, using a bladder scanner to assist traditional urinary incontinence care may reduce the amount of daytime urine loss and use of incontinence pads without increasing caregivers’ care burden.

Adding a bladder scanner to urinary incontinence care may not impact patient quality of life, mental state, depression, physical function, and level of motivation.

These findings were based on 2 studies, 1 of which lacked a control group and did not directly measure the effect of adding a bladder scanner to urinary incontinence care on patients’ urine loss. This may limit our confidence in the findings.

We did not find any studies that reported on the effect of using bladder scanners in the personal care setting on rates of catheterization, emergency department visits, urinary tract infections, or other harms. We also did not identify any cost-effectiveness studies or evidence-based guidelines that met inclusion criteria for this report.

Key Message

The clinical effectiveness of oseltamivir for the prevention of influenza in residents of long-term care facilities compared to no prophylaxis is unclear. The evidence we identified is inconclusive due to limitations in the quality of studies.

We did not find any evidence on the safety of oseltamivir for preventing influenza in long-term care facilities.

We did not find any studies on the clinical effectiveness or safety of oseltamivir prophylaxis in long-term care facilities compared to placebo.

Key Message

Reactive air surfaces, alternating-pressure (active) air surfaces, and reactive gel surfaces may be more effective at preventing pressure injuries compared to foam surfaces. The clinical effectiveness of therapeutic support surfaces to prevent pressure injuries may be influenced by the care setting (e.g., long-term care, acute care, intensive care units) as well as follow-up time.

An overview of reviews with a network meta-analysis did not find any significant differences between different types of support surfaces on time to pressure injury. However, limited evidence suggests there may be a difference between foam surfaces, compared to other types of foam surfaces.

Specialized skin protection cushions may also help to prevent pressure injuries compared to standard foam cushions, though there may be no difference between different types of air cushions.

It was unclear if there are significant differences between support surfaces for the treatment of pressure injuries. Authors of an overview of reviews stated that reactive air surfaces may be more effective than foam surfaces, but this was not statistically significant.

Limited evidence was identified regarding adverse events and health-related quality of life, as well as for pediatric patients.

Limited evidence was identified for support surfaces other than mattresses, beds, and overlays (e.g., cushions), as well as therapeutic small devices for prevention of pressure injuries. No studies were identified for therapeutic small devices for treatment.

Key Message

Three systematic reviews were identified regarding the clinical utility of screening for impaired vision versus no screening in adults aged 65 years and older.

Three evidence-based guidelines were identified regarding the use of screening for impaired vision in adults aged 65 years and older.

Key Message

Studies describing the clinical effectiveness of robotic-assisted surgical systems for hip arthroplasty reported variable results, with some findings indicating a benefit of robotic-assisted surgical systems, few findings indicating a benefit of conventional or manual surgical procedures, and most findings describing no difference between interventions.

Complications of robotic-assisted surgical systems for hip arthroplasty as compared to conventional or manual surgical procedures were generally found to have few differences found between treatment groups.

Cost-effectiveness evidence describing robotic-assisted surgical systems for hip arthroplasty was scarce, with 1 study identified by this review that bore limited relevance to the Canadian context.

The quality of currently available evidence describing the clinical effectiveness of robotic-assisted surgical systems for hip arthroplasty is low, indicating the importance of more rigorous research (including randomized controlled trials) addressing this topic.

Cost-effectiveness evidence relevant to the Canadian and/or public-payer context is needed.