Author Identifier (ORCID)
Abstract
Despite widespread development of prognostic risk stratification tools, their implementation in Australian healthcare remains poorly characterised. This review identified tools implemented for adults aged ≥40 years and examined their real-world use. Following PRISMA and SWiM guidelines, MEDLINE, EMBASE, Web of Science, PsycINFO, and CINAHL Plus were searched from inception to 20th February 2026. Eligible studies reported implementation of a risk stratification tool in Australian healthcare and health, functional, or implementation outcomes. The Mixed Methods Appraisal Tool assessed study quality. Of 7115 records screened, 21 studies were included across primary care, hospitals, residential aged care, and community services. Interventions included electronic decision support, multifactorial assessments, structured clinical protocols, and AI-enabled screening. Studies that focused on early implementation outcomes (acceptability, feasibility, and adoption) rarely examined sustainability, penetration, and cost. Risk stratification tools are feasible and acceptable across Australian healthcare settings, but few are implemented as part of routine care. Registration: PROSPERO—CRD420251028985.
Keywords
implementation science, prediction model, risk assessment, risk stratification
Document Type
Journal Article
Date of Publication
1-1-2026
Article Number
101910
Publication Title
The Lancet Regional Health - Western Pacific
Publisher
Elsevier
School
Centre for Precision Health
Funding Information
The authors would like to thank the Dementia Centre of Excellence and the enAble Institute for funding this project. BCMS was supported by Dementia Australia through the Dementia Australia Chair. ET is supported by a National Institute for Health and Care Research (NIHR) Advanced Fellowship (NIHR304435). SS is supported by a La Caixa Junior Leader Postdoctoral Fellowship (LCF/BQ/PI24/12040008). EB is supported by a National Health and Medical Research Council (NHMRC) Investigator Grant (GNT1174739).
Funding received from the National Health and Medical Research Council (NHMRC)
GNT1174739
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Recommended Citation
Greene, L., Brain, J., Brown, B., Burley, C. V., Burton, E., Guan, Z., Myers, B., Ride, K., Sabatini, S., Siervo, M., Tadesse, A. W., Tang, E. Y. H., Stephan, B. C., & Dunne, J. (2026). Implementation of risk prediction and stratification approaches for ageing populations in Australian healthcare: a systematic review. The Lancet Regional Health - Western Pacific, 72, Article 101910. https://doi.org/10.1016/j.lanwpc.2026.101910