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. 2021 Mar 26;10(1):83.
doi: 10.1186/s13643-021-01638-0.

Frailty inclusive care in acute and community-based settings: a systematic review protocol

Carmel L Montgomery  1   2 , Gareth Hopkin  3 , Sean M Bagshaw  4   5 , Erin Hessey  6 , Darryl B Rolfson  6
Affiliations

Frailty inclusive care in acute and community-based settings: a systematic review protocol

Carmel L Montgomery et al. Syst Rev. .

Abstract

Background: Frailty is a known risk factor for an array of adverse outcomes including more frequent and prolonged health services use and high health care costs. Aging of the population has implications for care provision across the care continuum, particularly for people living with frailty. Despite known risks associated with frailty, there has been limited research on care pathways that address the needs of persons living with frailty. Our study aims to review and examine, in a rigorous way, the quality of evidence for multi-component interventions and care pathways focused on frailty.

Methods: A comprehensive electronic search strategy will be used to identify studies that evaluate multi-component interventions or care pathways for persons living with frailty. The search strategy will include terms for frailty, multi-component interventions, effectiveness, and cost effectiveness applied to the following databases: MEDLINE (OVID), EMBASE (OVID), CINAHL (EBSCO), Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Database of Systematic Reviews. An adapted search for Google Scholar and gray literature databases will also be used. References of included studies will be hand-searched for additional citations of frailty-inclusive care. Known experts and corresponding authors of identified articles will be contacted by email to identify further eligible studies. Risk of bias will be assessed using the Effective Public Health Practice Project Quality Assessment tool. Data will be extracted from eligible studies and it is anticipated that narrative analysis will be used. If studies with sufficient homogeneity are found, then pooled effects will be reported using meta-analysis.

Discussion: This review will appraise the evidence currently available on multi-component frailty interventions. Results will inform on clinical pathway development for people living with frailty across the care continuum and will guide future research to address gaps in the literature and areas in need of further development.

Systematic review registration: PROSPERO CRD42020166733.

Keywords: Cost effectiveness; Frailty; Multi-component interventions.

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Conflict of interest statement

All authors report no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work.

Carmel Montgomery is supported by a Network of Alberta Health Economists fellowship award and was a 2017 Canadian Frailty Network Interdisciplinary Fellow. Dr. Bagshaw holds a Canada Research Chair in Critical Care Nephrology and is a scientific director for the Alberta Health Services Critical Care Strategic Clinical Network. Dr. Rolfson was a key member of the research group that developed and validated the Edmonton Frail Scale.

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