Nutri rition a and Ac Activity ty Clinical Practi ctice Guideline for O r Older r Ad Adults Livi ving w with F Frailty Jayna Holroyd-Leduc, MD FRCPC Chair, CFN KT Committee Head and Professor, Div. of Geriatric Medicine, U of Calgary 1
CPG: St CP Steer eerin ing Co Commit ittee e • Jayna Holroyd-Leduc (University of Calgary) • John Muscedere (Queens University) • Anik Giguere (Laval University) • Leah Gramlich (University of Alberta) • Heather Keller (University of Waterloo) • Ada Tang (McMaster University) • Danielle Bouchard (University of New Brunswick) • Amanda Lorbergs (CFN) 2
CPG: Evidence Rev eview w • Partnered with MERST (McMaster Evidence Review and Synthesis Team) • Topic areas refined • 2 separate reviews • PICOS • Search strategy • Peer review of PICOS and search strategy • Protocols registered with PROSPERO • Follow PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement • GRADE quality analysis 3
CPG PG: Nutri rition Revi view • QUESTION : What is the effectiveness of nutritional interventions on older adults (age 65+) living with frailty or pre-frailty on outcomes? What are the associated harms? • Databases Search : MEDLINE, Embase, Cochrane databases • Search results: 3158 citations; 119 full text • P (population): adults 65+ with frailty/pre-frailty • I (intervention): any nutrition intervention • C (control): any comparison group • O (outcomes): body weight, frailty, function, grip strength, sarcopenia, QoL, LTC admission, hospital LOS, hospital admission, mobility, diet quality, caregiver social support, harms • S (study design): RCT, quasi-experimental trials, observational cohorts with comparison group 4
CPG PG: Ph Physical Ac Activi vity R Revi view • QUESTION : What is the effectiveness of physical activity interventions on older adults (age 65+) living with frailty or pre-frailty on outcomes? What are the associated harms? • Databases Searched : MEDLINE, Embase, Cochrane databases • Search results: 4709 citations; 283 full text • P (population): adults 65+ with frailty/pre-frailty • I (intervention): any physical activity intervention • C (control): any comparison group • O (outcomes): mobility, fall incidence or fall rate (total, injurious), QoL, function, muscle strength or power, physical activity level, mood, LTC admissions, hospital admissions, hospital LOS, caregiver burden, harms • S (study design): RCT, quasi-experimental trials, observational cohorts with comparison group 5
CPG: Gu Guidel eline e Devel elop opmen ent Proc oces ess • Develop Guideline Consensus Panel • Engaging appropriate stakeholders, organizations and content experts • Review quality and strength of evidence • GRADE (Grading of Recommendations Assessment, Development and Evaluation) assessment • Develop evidence statements • Develop recommendations and strength statements • Develop Clinical Practice Guideline (CPG) • Peer review of CPG • Develop KT plan (activities and tools) • Dissemination; Knowledge transfer and exchange initiatives 6
CPG: G: T Timel eline, Deliver erables les, a and M Miles eston ones September 2020 • CPGs published * • Topic refinement March 2020 • Begin widespread Submit systematic reviews to • Protocol development dissemination and peer-reviewed journal(s) • Identification of key stakeholders implementation • Solicit interest of end-users in CPGs development and dissemination 2 0 1 9 2 0 2 0 • Statistical analysis • Protocol registration • Submit CPGs to (including GRADE analysis) • Literature search peer-reviewed journal(s) • Citation screening • Evidence synthesis • Data extraction April 2020: Consensus Panel meeting Assess level of certainty in evidence Draft recommendation and strength statements
Inter eres ested ed in becom oming i g invol olved ed? • Consensus Panel Meeting (April 29 in Calgary) • Dissemination and Knowledge Transfer and Exchange Activities • CONTACT: Amanda Lorbergs amanda@cfn-nce.ca 8
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