The Asia-Pacific Clinical Practice Guidelines for the Management of Frailty

Elsa Dent, Christopher Lien, Wee Shiong Lim, Wei Chin Wong, Chek Hooi Wong, Tze Pin Ng, Jean Woo, Birong Dong, Shelley de la Vega, Philip Jun Hua Poi, Shahrul Bahyah Binti Kamaruzzaman, Chang Won, Liang Kung Chen, Kenneth Rockwood, Hidenori Arai, Leocadio Rodriguez-Mañas, Li Cao, Matteo Cesari, Piu Chan, Edward LeungFrancesco Landi, Linda P. Fried, John E. Morley, Bruno Vellas, Leon Flicker

Research output: Contribution to journalArticle

132 Citations (Scopus)

Abstract

Objective To develop Clinical Practice Guidelines for the screening, assessment and management of the geriatric condition of frailty. Methods An adapted Grading of Recommendations, Assessment, Development, and Evaluation approach was used to develop the guidelines. This process involved detailed evaluation of the current scientific evidence paired with expert panel interpretation. Three categories of Clinical Practice Guidelines recommendations were developed: strong, conditional, and no recommendation. Recommendations Strong recommendations were (1) use a validated measurement tool to identify frailty; (2) prescribe physical activity with a resistance training component; and (3) address polypharmacy by reducing or deprescribing any inappropriate/superfluous medications. Conditional recommendations were (1) screen for, and address modifiable causes of fatigue; (2) for persons exhibiting unintentional weight loss, screen for reversible causes and consider food fortification and protein/caloric supplementation; and (3) prescribe vitamin D for individuals deficient in vitamin D. No recommendation was given regarding the provision of a patient support and education plan. Conclusions The recommendations provided herein are intended for use by healthcare providers in their management of older adults with frailty in the Asia Pacific region. It is proposed that regional guideline support committees be formed to help provide regular updates to these evidence-based guidelines.

Original languageEnglish
Pages (from-to)564-575
Number of pages12
JournalJournal of the American Medical Directors Association
Volume18
Issue number7
DOIs
Publication statusPublished - 1 Jul 2017
Externally publishedYes

Keywords

  • aged
  • disease management
  • evidence-based medicine/standards*
  • Frail elderly
  • patient care management
  • Practice Guidelines as Topic*

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  • Cite this

    Dent, E., Lien, C., Lim, W. S., Wong, W. C., Wong, C. H., Ng, T. P., Woo, J., Dong, B., de la Vega, S., Hua Poi, P. J., Kamaruzzaman, S. B. B., Won, C., Chen, L. K., Rockwood, K., Arai, H., Rodriguez-Mañas, L., Cao, L., Cesari, M., Chan, P., ... Flicker, L. (2017). The Asia-Pacific Clinical Practice Guidelines for the Management of Frailty. Journal of the American Medical Directors Association, 18(7), 564-575. https://doi.org/10.1016/j.jamda.2017.04.018