Abstract
BackgroundFrailty 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.MethodsA 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.DiscussionThis 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 registrationPROSPERO CRD42020166733
Highlights
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
This status can be captured by measuring frailty, an agerelated state of increased vulnerability with disproportionate changes in health status in response to stressors [3]. This creates the opportunity to develop and implement care protocols that are tailored to the health needs of persons who live with frailty
Frailty is a relatively new term, and describes both the state of exaggerated vulnerability associated with agerelated deficit accumulation, and the associated multidimensional syndrome
Summary
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. The general health and functional status of patients prior to acute illness and other stressors are accepted as important determinants of hospital outcomes [1, 2]. This status can be captured by measuring frailty, an agerelated state of increased vulnerability with disproportionate changes in health status in response to stressors [3]. This creates the opportunity to develop and implement care protocols that are tailored to the health needs of persons who live with frailty. Frailty in hospitalized patients has been associated with gradient increases in hospital mortality, intensity of organ support, frequency and duration of health services use, and cost, when compared to non-frail patients [8,9,10]
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