Integrated care models for managing and preventing frailty: A systematic review for the European Joint Action on Frailty Prevention (ADVANTAGE JA)
Author
Hendry, Anne
Vanhecke, Eliane
Carriaz, Ana Maria
López-Samaniego, Luz
Espinosa, Juan Manuel
Sezgin, Duygu
O’Donovan, Mark
Hammar, Teija
Ferry, Peter
Vella, Antoine
Bacaicoa, Olatz Albaina
Braga, Mario
Ciutan, Marius
Velivasi, Alexandra
Lamprini, Koula Maria
Van der Heyden, Johan
Liew, Aaron
O'Caoimh, Rónán
Metadata
Show full item recordAbstract
Frailty requires concerted integrated
approaches to prevent functional decline. Although
there is evidence that integrating care is effective for
older people, there is insufficient data on outcomes
from studies implementing integrated care to prevent
and manage frailty. We systematically searched
PubMed and Cochrane Library database for peerreviewed medical literature on models of care for
frailty, published from 2002 to 2017. We considered
the effective and transferable components of the
models of care and evidence of economic impact,
where available. Information on European Unionfunded projects or those registered with the European
Innovation Partnership on Active and Healthy
Ageing, and grey literature (including good practices)
were also considered. We found 1,065 potential
citations and 170 relevant abstracts. After excluding
reports on specific diseases, processes or
interventions and service models that did not report
data, 42 full papers met the inclusion criteria. The
evidence showed that few models of integrated care
were specifically designed to prevent and tackle
frailty in the community and at the interface between
primary and secondary (hospital) care. Current
evidence supports the case for a more holistic and
salutogenic response to frailty, blending a chronic
care approach with education, enablement and
rehabilitation to optimise function, particularly at
times of a sudden deterioration in health, or when
transitioning between home, hospital or care home. In
all care settings, these approaches should be supported
by comprehensive assessment and multidimensional
interventions tailored to modifiable physical,
psychological, cognitive and social factors.