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. 2021;38(3):e2021031.
doi: 10.36141/svdld.v38i3.11599. Epub 2021 Sep 30.

Frailty and chronic respiratory disease: the need for a multidisciplinary care model

Emmanouil K Symvoulakis  1 , Apostolos Kamekis  2 , Elena Drakonaki  3 , Semeli Mastrodemou  4 , Christopher J Ryerson  5 , Katerina Antoniou  4
Affiliations

Frailty and chronic respiratory disease: the need for a multidisciplinary care model

Emmanouil K Symvoulakis et al. Sarcoidosis Vasc Diffuse Lung Dis. 2021.

Abstract

Background: Frailty is a state of increased vulnerability to various health stressors but little information is summarized about frailty in patients with specific chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and asthma.

Objective: We aimed to describe the burden of frailty on patients with chronic respiratory disorders and to discuss the need for multidisciplinary care services.

Methods: PubMed and Cochrane Central databases were systematically reviewed for studies reporting outcomes associated with frailty in COPD, IPF, and asthma. Electronic databases were searched for relevant articles published in English from 2010 up to July 2020. Appraisal was carried out based on the Hierarchy of Evidence Rating System and the GRADE guidelines.

Results: A total of 31 articles met all inclusion criteria with 24 of them at level IV, 1 at level V, and 6 at level VI. Frailty is likely to negatively affect quality of life and to increase the risk of mortality, especially in elderly with COPD, IPF and asthma. Each disease has a particular effect on the balance between health status, respiratory impairment and frailty. A greater understanding of frailty phenotype across different ages, as well as in a range of long-term conditions, is of great necessity in both clinical and research settings. Limited conformity was observed between different methodologies and nature of chronic diseases studied, leading to a further difficulty to extract homogeneous information.

Conclusion: Literature shows that frailty is prevalent in COPD, IPF, and asthma, after adjusting for shared risk factors. Our findings suggest that frailty should be approached as an entity per se', in order to assess real mortality risk, alongside respiratory disease severity and the presence of comorbidities. Health care professionals need knowledge, skills and multidisciplinary collaboration to buffer the impact of frailty on everyday practice.

Keywords: frailty; health care; quality of life; respiratory diseases.

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Conflict of interest statement

EKS conceived the study idea, invited team members and offered a guidance to search topic. AK performed the literature search and composed results section by appraising findings for the studies included. AK and EKS cross-checked the emerged literature information. KA critically reviewed literature information and offered clinical input when this was necessary. AK, EKS and KA contributed to the first draft preparation. ED and CJR offered intellectual input and contributed in the draft writing and revision based on the field of their expertise. All authors read and approved final manuscriptWe would like to thank Professor Jeffrey J. Swigris for his intellectual input and advice during writing the first draft.Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram for database search and study selection process. (Based on Moher et al. (18))
See this image and copyright information in PMC

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