0000000000920713
AUTHOR
Holly Gwyther
Perceptions and experiences of frailty interventions: quantitative and qualitative results from a survey of partners within the European Innovation Partnership on Active and Healthy Ageing (EIP-AHA)
ABSTRACTThe European Innovation Partnership on Active and Healthy Ageing (EIP-AHA) was launched by the European Commission in 2011 to promote innovation in ageing research. This paper explores the experiences of partners delivering frailty interventions within Europe, registering their programmes with the EIP-AHA. Data were collected using an online survey from 21 partners in seven countries. A mixed-method approach was used with inductive thematic analysis of free-text responses to improve data richness. Responses indicated that there was a lack of consistency between EIP-AHA partners in methods of defining, screening and measuring for frailty and pre-frailty. Open responses to survey ques…
Understanding frailty:meanings and beliefs about screening and prevention across key stakeholder groups in Europe
Innovative methods to manage frailty are critical to managing the needs of an ageing population. Evidence suggests there are opportunities to reverse or prevent frailty through early intervention. However, little is known about older adults’, families’ and practitioners’ beliefs about the malleability of frailty. This study examined European stakeholders’ accounts of the acceptability and feasibility of frailty screening and prevention to inform future intervention development. Semi-structured focus groups and individual interviews were conducted in three European Union countries (Italy, Poland and the United Kingdom) with key stakeholders – frail and non-frail older adults, family care-giv…
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Additional file 3: Table S1. Table that describes the members of the FOCUS Guideline Panel and their role in the development of the guidelines.
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Additional file 4. Example of the output of the voting process using the Evidence to Decision template, as received and processed by the guidelines technical team.
Understanding frailty: meanings and beliefs about screening and prevention across key stakeholder groups in Europe
ABSTRACTInnovative methods to manage frailty are critical to managing the needs of an ageing population. Evidence suggests there are opportunities to reverse or prevent frailty through early intervention. However, little is known about older adults’, families’ and practitioners’ beliefs about the malleability of frailty. This study examined European stakeholders’ accounts of the acceptability and feasibility of frailty screening and prevention to inform future intervention development. Semi-structured focus groups and individual interviews were conducted in three European Union countries (Italy, Poland and the United Kingdom) with key stakeholders – frail and non-frail older adults, family …
Perceptions and experiences of frailty interventions:quantitative and qualitative results from a survey of partners within the European Innovation Partnership on Active and Healthy Ageing (EIP-AHA)
The European Innovation Partnership on Active and Healthy Ageing (EIP-AHA) was launched by the European Commission in 2011 to promote innovation in ageing research. This paper explores the experiences of partners delivering frailty interventions within Europe, registering their programmes with the EIP-AHA. Data were collected using an online survey from 21 partners in seven countries. A mixed-method approach was used with inductive thematic analysis of free-text responses to improve data richness. Responses indicated that there was a lack of consistency between EIP-AHA partners in methods of defining, screening and measuring for frailty and pre-frailty. Open responses to survey questions ab…
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Additional file 1. Synthesis of quantitative evidence from the FOCUS systematic review [9], showing the effect of the interventions on frailty as an outcome, adapted from the typical GRADE Summary of Findings table structure, as offered to the guideline panellists.
Patient-centred access to health care: a framework analysis of the care interface for frail older adults
Abstract Background The objective of this study was to explore the issues surrounding access to health and social care services for frail older adults with Polish stakeholders, including healthy and frail/pre-frail older adults, health care providers, social care providers, and caregivers, in order to determine their views and perspectives on the current system and to present suggestions for the future development of a more accessible and person-centred health and social care system. Methods Focus groups were used to gather qualitative data from stakeholders. Data were analysed using framework analysis according to five dimensions of accessibility to care: approachability, acceptability, av…
A qualitative study examining everyday frailty management strategies adopted by Polish stakeholders
Abstract Background: Frailty is a multidimensional clinical state that is common in older age and can be managed through intervention. Strategies to manage frailty have not been previously explored with stakeholders in Poland. This may stem from misperceptions about the nature and malleability of frailty, which has resulted in it being viewed as a lower priority healthcare concern. Objectives: To explore stakeholders’ views to determine whether there are effective everyday strategies that they can adopt to reduce, reverse or prevent frailty. Methods: Semi-structured focus groups were conducted with five stakeholder groups (frail/pre-frail and robust older adults, health and social care prof…
The pros and cons of the implementation of a chronic care model in European rural primary care: the points of view of European rural general practitioners
Introduction: This article describes the views of European rural general practitioners regarding the strengths, weaknesses, opportunities and threats (SWOT) of the implementation of a chronic care model (CCM) in European rural primary care. Methods: This was a mixed-methods online survey. Data were collected from 227 general practitioners between May and December 2017. Categorical data were analysed using descriptive methods while free-text responses were analysed using qualitative methods. The setting was rural primary care in nine European countries (including Central and Eastern Europe). Main outcomes measures were respondents' evaluations of a chronic care model in their rural heal…
The use of technology in the context of frailty screening and management interventions: a study of stakeholders’ perspectives
Abstract Background Health and social care interventions show promise as a way of managing the progression of frailty in older adults. Information technology could improve the availability of interventions and services for older adults. The views of stakeholders on the acceptability of technological solutions for frailty screening and management have not been explored. Methods Focus groups were used to gather data from healthy and frail/pre-frail older adults, health and social care providers, and caregivers in three European countries – Italy, Poland and UK. Data were analysed using framework analysis in terms of facilitators or determinants of older adults’ adoption of technology. Results…
Effectiveness of interventions to prevent pre-frailty and frailty progression in older adults: a systematic review
OBJECTIVE: To summarize the best available evidence regarding the effectiveness of interventions for preventing frailty progression in older adults. INTRODUCTION: Frailty is an age-related state of decreased physiological reserves characterized by an increased risk of poor clinical outcomes. Evidence supporting the malleability of frailty, its prevention and treatment, has been presented. INCLUSION CRITERIA: The review considered studies on older adults aged 65 and over, explicitly identified as pre-frail or frail, who had been undergoing interventions focusing on the prevention of frailty progression. Participants selected on the basis of specific illness or with a terminal diagnosis were …
A realist review to understand the efficacy and outcomes of interventions designed to minimise, reverse or prevent the progression of frailty.
Interventions to minimise, reverse or prevent the progression of frailty in older adults represent a potentially viable route to improving quality of life and care needs in older adults. Intervention methods used across European Innovation Partnership on Active and Healthy Ageing collaborators were analysed, along with findings from literature reviews to determine 'what works for whom in what circumstances'. A realist review of FOCUS study literature reviews, 'real-world' studies and grey literature was conducted according to RAMESES (Realist and Meta-narrative Evidence Synthesis: Evolving Standards), and used to populate a framework analysis of theories of why frailty interventions worked,…
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Additional file 5. Detailed justification for the judgement upon each Evidence to Decision criterion, for each guideline.
Understanding frailty:a qualitative study of European healthcare policy-makers' approaches to frailty screening and management
ObjectiveTo elicit European healthcare policy-makers’ views, understanding and attitudes about the implementation of frailty screening and management strategies and responses to stakeholders’ views.DesignThematic analysis of semistructured qualitative interviews.SettingEuropean healthcare policy departments.ParticipantsSeven European healthcare policy-makers representing the European Union (n=2), UK (n=2), Italy (n=1), Spain (n=1) and Poland (n=1). Participants were sourced through professional networks and the European Commission Authentication Service website and were required to be in an active healthcare policy or decision-making role.ResultsSeven themes were identified. Our findings re…
Interventions to prevent, delay or reverse frailty in older people: a journey towards clinical guidelines
AbstractBackgroundAge-related frailty is a multidimensional dynamic condition associated with adverse patient outcomes and high costs for health systems. Several interventions have been proposed to tackle frailty. This correspondence article describes the journey through the development of evidence- and consensus-based guidelines on interventions aimed at preventing, delaying or reversing frailty in the context of the FOCUS (Frailty Management Optimisation through EIP-AHA Commitments and Utilisation of Stakeholders Input) project (664367-FOCUS-HP-PJ-2014). The rationale, framework, processes and content of the guidelines are described.Main textThe guidelines were framed into four questions …
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Additional file 2. Narrative synthesis of the effect of interventions on secondary outcomes, as offered to the guideline panellists.