Njoku, Chidiamara M., Barnett, Fiona, Singh, Maria Fiatarone A., Valenzuela, Trinidad, and Inskip, Michael (2024) Multifaceted Interventions Inclusive of Medication Optimization for Frailty in Aged Care: A Systematic Review. The Journal of the American Medical Directors Association, 25. 105111.

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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.

Item ID:	83286
Item Type:	Article (Research - C1)
ISSN:	1538-9375
Keywords:	Exercise,frailty,gerontology,long-term care,medication optimization,nutrition
Related URLs:	https://www.jamda.com/article/S1525-8610...
Copyright Information:	© 2024 AMDA e The Society for Post-Acute and Long-Term Care Medicine.
Additional Information:	Please do not make PDF available as it is not open access
Date Deposited:	30 Jul 2024 00:51
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