Experiences of older adults accessing specialized healthcare services in rural or remote areas: a systematic review protocol.

Objective: The objective of this review is to synthesize the literature on the experiences of older adults accessing specialized healthcare services while living in remote or rural areas.

Introduction: Older persons with chronic illnesses often need specialized healthcare services. Those who live in remote or rural areas may have limited access to these specialized healthcare services, potentially leading to an increase in morbidity and mortality. Little is known about the experience of older adults accessing specialized healthcare services while living in remote or rural areas.

Inclusion Criteria: This review will consider studies of persons 65 years and over who have self-identified as living in remote or rural areas. They will have on at least one occasion sought access in person to specialized healthcare services for a chronic condition(s) such as cardiovascular diseases, renal diseases, diabetes, cancers, mental illness or a major health concern beyond the scope of a primary care clinician, such as palliative care.

Methods: The search strategy will aim to find published and unpublished studies in English from 1980. Databases to be searched include: CINAHL, PubMed, PsycINFO, AgeLine, ProQuest Dissertations and Theses, Google Scholar and MedNar. Titles and abstracts will be screened against the inclusion criteria. Papers meeting the inclusion criteria will be appraised by two independent reviewers for methodological quality. Data will be extracted by two independent reviewers using a standardized data extraction tool. Findings will be pooled with the meta-aggregation approach, and a ConQual Summary of Findings will be presented.