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A Systematic Review of Clinical Practice Guidelines for Identification and Management of Frailty

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The journal of nutrition, health & aging

Abstract

Objective

This study aims to appraise and summarize consistent recommendations from clinical practice guidelines (CPGs) for identification and management of frailty to maintain and improve functional independence of elderly population.

Methods

A systematic search of Ovid MEDLINE, Embase, PubMed, PsycINFO, and CINAHL electronic databases using database-specific search terms in two broad areas “guidelines” and “frailty”, and a manual search of websites with the key phrase “frailty guideline” was performed. The inclusion criteria included CPGs focusing on identifying and managing frailty in population >65 years old, published in English since January 2010. Three reviewers independently assessed guideline quality using the AGREE II instrument. Data extraction was performed, followed by compilation and comparison of all recommendations to identify the key consistent recommendations.

Results

Six CPGs met the inclusion criteria; however, only three CPGs had high methodological quality in accordance with AGREE II appraisal. The average AGREE II scores of all six CPGs were: 84.5%, 68%, 46.5%, 81.5%, 56.3%, and 60.2% for domains 1–6 (scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability, and editorial independence) respectively. A total of 54 recommendations were identified, with 12 key recommendations suggested frequently by the CPGs.

Conclusion

The AGREE II instrument identified strengths and weaknesses of the CPGs, but failed to assess clinical implications and feasibility of the guidelines. Further research is needed to improve clinical relevance of CPGs in the identification and management of frailty. The feasibility in implementing these guidelines with regards to cost-effectiveness of frailty screening warrants further investigation.

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Acknowledgements

The authors would like to thank subject librarian Ms. Thelma Fisher (University of Otago) for her expertise and guidance in performing electronic database searches for the systematic review.

Funding

Funding: None.

Author information

Authors and Affiliations

  1. Graduate School of Health, Discipline of Physiotherapy, University of Technology Sydney, Sydney, Australia

    P. Mehta

  2. School of Physiotherapy, Centre for Health Activity and Rehabilitation Research, University of Otago, Dunedin, New Zealand

    G. Lemon, L. Hight, A. Allan, C. Li, S. K. Pandher, J. Brennan & Debra L. Waters

  3. Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates

    A. Arumugam

  4. Adjunct Faculty, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India

    A. Arumugam

  5. Adjunct Faculty, Department of Physiotherapy, Binawan University, Binawan, Indonesia

    A. Arumugam

  6. Department of Medicine, University of Otago, Otago Medical School, Dunedin, New Zealand

    X. Walker & Debra L. Waters

  7. Director of Gerontology Research, University of Otago, School of Physiotherapy and Department of Medicine, PO Box 56, Dunedin, New Zealand, 9054

    Debra L. Waters

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  1. P. Mehta
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Correspondence to Debra L. Waters.

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Mehta, P., Lemon, G., Hight, L. et al. A Systematic Review of Clinical Practice Guidelines for Identification and Management of Frailty. J Nutr Health Aging 25, 382–391 (2021). https://doi.org/10.1007/s12603-020-1549-3

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  • DOI: https://doi.org/10.1007/s12603-020-1549-3

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