The Asia-Pacific clinical practice guidelines for the management of frailty

Dent, Elsa, Lien, Christopher, Lim, Wee Shiong, Wong, Wei Chin, Wong, Chek Hooi, Ng, Tze Pin, Woo, Jean, Dong, Birong, de la Vega, Shelley, Poi, Philip Jun Hua, Kamaruzzaman, Shahrul Bahyah Binti, Won, Chang, Chen, Liang-Kung, Rockwood, Kenneth, Arai, Hidenori, Rodriguez-Manas, Leocadio, Cao, Li, Cesari, Matteo, Chan, Piu, Leung, Edward, Landi, Francesco, Fried, Linda P., Morley, John E., Vellas, Bruno and Flicker, Leon (2017) The Asia-Pacific clinical practice guidelines for the management of frailty. Journal of the American Medical Directors Association, 18 7: 564-575. doi:10.1016/j.jamda.2017.04.018


Author Dent, Elsa
Lien, Christopher
Lim, Wee Shiong
Wong, Wei Chin
Wong, Chek Hooi
Ng, Tze Pin
Woo, Jean
Dong, Birong
de la Vega, Shelley
Poi, Philip Jun Hua
Kamaruzzaman, Shahrul Bahyah Binti
Won, Chang
Chen, Liang-Kung
Rockwood, Kenneth
Arai, Hidenori
Rodriguez-Manas, Leocadio
Cao, Li
Cesari, Matteo
Chan, Piu
Leung, Edward
Landi, Francesco
Fried, Linda P.
Morley, John E.
Vellas, Bruno
Flicker, Leon
Title The Asia-Pacific clinical practice guidelines for the management of frailty
Journal name Journal of the American Medical Directors Association   Check publisher's open access policy
ISSN 1538-9375
1525-8610
Publication date 2017-07-01
Sub-type Article (original research)
DOI 10.1016/j.jamda.2017.04.018
Open Access Status Not yet assessed
Volume 18
Issue 7
Start page 564
End page 575
Total pages 12
Place of publication Philadelphia, PA, United States
Publisher Elsevier
Language eng
Subject 2900 Nursing
2719 Health Policy
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.
Formatted 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.
Keyword Aged
Disease management
Evidence-based medicine/standards
Frail elderly
Patient care management
Practice Guidelines as Topic
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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Centre for Health Services Research Publications
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