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Clinical practice guidelines for the prevention and management of frailty: A systematic review
Lufang Zheng1, Guichen Li1, Yiming Qiu1
1School of Nursing, Jilin University, Changchun, China.
Aims:
To systematically search for clinical practice guidelines focusing on the prevention and management of frailty, to evaluate their methodological quality and to synthesize the consensus recommendations.
Design:
A systematic review.
Data Sources:
Guideline websites, related professional association websites and electronic databases were systematically searched through 4 November 2020.
Review Methods:
We evaluated the methodological quality of the eligible guidelines using the Appraisal of Guidelines Research and Evaluation II (AGREE II). Two reviewers synthesized the consensus recommendations proposed by at least two guidelines.
Results:
Eight guidelines met the eligibility criteria and were included in the review. The mean scores of the six domains were as follows: the 'scope and purpose' domain scored 88.0%, the 'clarity of presentation' domain scored 81.9%, the 'stakeholder involvement' domain scored 63.4%, the 'editorial independence' domain scored 62.2%, the 'rigour of development' domain scored 61.1% and the 'applicability' domain scored 57.8%. In total, we synthesized 23 recommendations for the prevention and management of frailty that are consistent among the included guidelines.
Conclusions:
The number of clinical practice guidelines for the prevention and management of frailty is limited. The methodological quality of existing guidelines needs to be improved. Our synthesized findings provide an intuitive, convenient and summative reference resource for frailty prevention and management. It' is worth noting that recommendations described in the included guidelines require additional detail.
Impact:
Although the prevention and management of frailty is urgent, there is currently a lack of evidences guiding these processes, especially in the prevention. The methodological quality of existing guidelines is insufficient, and the recommendations described in the guidelines require additional detail. Therefore, users of these guidelines, especially nurses, should make a careful decision according to the specific situation when using. Nurses also have a key role in providing more clinical evidences for the improvement of the quality of the guidelines.
Insights
Clinical practice guidelines for frailty prevention and management are limited and require methodological improvement. This review synthesizes 23 consensus recommendations to aid clinicians in managing frailty.
Area of Science:
- Gerontology
- Evidence-Based Medicine
- Clinical Practice Guidelines
Background:
- Frailty is a growing concern in aging populations, necessitating evidence-based management strategies.
- Existing clinical practice guidelines (CPGs) for frailty prevention and management are scarce and vary in quality.
- There is a need to synthesize current recommendations to support clinical decision-making.
Purpose of the Study:
- To systematically identify and evaluate CPGs for frailty prevention and management.
- To assess the methodological quality of identified guidelines using the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument.
- To synthesize consensus recommendations from high-quality guidelines.
Main Methods:
- A systematic review of guideline databases, professional association websites, and electronic databases was conducted.
- Eligible guidelines were assessed for methodological rigor using the AGREE II tool.
- Consensus recommendations, present in at least two guidelines, were synthesized.
Main Results:
- Eight guidelines met the inclusion criteria.
- Overall methodological quality scores indicated areas for improvement, particularly in 'rigour of development' (61.1%) and 'applicability' (57.8%).
- Twenty-three consensus recommendations for frailty prevention and management were synthesized.
Conclusions:
- The current body of CPGs for frailty is limited and requires enhancement in methodological quality.
- Synthesized recommendations offer a valuable resource, but require careful application due to a lack of detail.
- Nurses play a crucial role in applying guidelines judiciously and generating further evidence to improve guideline quality.
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