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Multifaceted Interventions Inclusive of Medication Optimization for Frailty in Aged Care: A Systematic Review.
Njoku, Chidiamara M; Barnett, Fiona; Fiatarone Singh, Maria A; Valenzuela, Trinidad; Inskip, Michael.
Afiliação
  • Njoku CM; College of Healthcare Sciences, Sport and Exercise Science, James Cook University, Townsville, Queensland, Australia. Electronic address: chidi.njoku@my.jcu.edu.au.
  • Barnett F; College of Healthcare Sciences, Sport and Exercise Science, James Cook University, Townsville, Queensland, Australia.
  • Fiatarone Singh MA; Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; The Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA; Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydne
  • Valenzuela T; College of Healthcare Sciences, Sport and Exercise Science, James Cook University, Townsville, Queensland, Australia; Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
  • Inskip M; College of Healthcare Sciences, Sport and Exercise Science, James Cook University, Townsville, Queensland, Australia; Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
J Am Med Dir Assoc ; 25(9): 105111, 2024 Sep.
Article em En | MEDLINE | ID: mdl-38964374
ABSTRACT

OBJECTIVES:

Implementation of best practice frailty guidelines in residential aged care is currently unclear, and there is a particular scarcity of evidence regarding multifaceted frailty treatments inclusive of medication optimization in these settings, despite the bidirectional relationship between polypharmacy and frailty. This review aimed to retrieve all relevant literature and evaluate the effect of medication optimization delivered in conjunction with exercise and/or nutritional interventions in the best-practice management of frailty in residential aged care.

DESIGN:

Systematic review with a qualitative synthesis. SETTINGS AND

PARTICIPANTS:

Older adults residing within residential aged care (otherwise referred to as nursing homes or long-term care).

METHODS:

The protocol was prospectively registered on PROSPERO (Reg. No. CRD42022372036) using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Five electronic databases were searched from inception to November 23, 2023, with alerts monitored until March 28, 2024. Quality of studies was assessed using the ROB 2 and ROBIN-1 tools.

RESULTS:

A total of 10,955 articles were retrieved; 62 full articles were reviewed, with 3 studies included (2 randomized controlled trials and 1 nonrandomized controlled trial) involving 1030 participants. Included studies did not use specific frailty scores but reported individual components of frailty such as weight loss or number of medications prescribed. No trial combining medication review, exercise, and nutrition was identified. Medication review reduced the number of medications prescribed, whereas the use of nutritional support reduced gastrointestinal medication and maintained weight. CONCLUSION AND IMPLICATIONS There is no published research investigating best-practice guidelines for medication optimization used in combination with both exercise and nutrition in aged care to address frailty. This review confirms the need for studies implementing Consensus Guidelines for frailty treatment in this vulnerable cohort.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Idoso Fragilizado / Casas de Saúde Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: J Am Med Dir Assoc Assunto da revista: HISTORIA DA MEDICINA / MEDICINA Ano de publicação: 2024 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Idoso Fragilizado / Casas de Saúde Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: J Am Med Dir Assoc Assunto da revista: HISTORIA DA MEDICINA / MEDICINA Ano de publicação: 2024 Tipo de documento: Article País de publicação: Estados Unidos