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Table 2 FOCUS guideline questions in the PICO format

From: Interventions to prevent, delay or reverse frailty in older people: a journey towards clinical guidelines

GQ – Should interventions to prevent or delay the progression of frailty, or to reverse frailty, be adopted in prefrail or frail older people?
Q1 – Should physical interventions be recommended to prevent or delay the progression of frailty, or to reverse frailty, in prefrail or frail older people?
Q2 – Should interventions based on tailored care and/or GEM be recommended to prevent or delay the progression of frailty, or to reverse frailty, in prefrail or frail older people?
Q3 – Should other interventions be recommended to prevent or delay the progression of frailty, or to reverse frailty, in prefrail or frail older people?
Patients: People aged 65 years or older, defined as prefrail or frail according to a pre-specified scale, index or criteria, not at the end-of-life phase or selected because of an index disease
Interventions:
GQ: Any intervention explicitly defined as an intervention for frailty (regardless of the definition of frailty used)
Q1: Physical interventions
 • Interventions based on exercise/physical activity
 • Nutritional interventions (e.g. diet change, supplementation)
 • Exercise/physical activity combined with nutritional interventions
Q2: Interventions based on tailored care and/or GEM
 • Uni-professional interventions based on tailored care/GEM
 • Multidisciplinary interventions based on tailored care/GEM
Q3: Other interventionsa
 • Cognitive training
 • A composite of exercise + nutritional supplementation + cognitive training
 • Exercise + nutritional consultation
 • Problem-solving therapy
 • Hormone therapy
 • Others
Reference intervention: No intervention or placebo or usual care
Outcomes:
 • Frailty – defined according to a composite index, or based on physical performance tests commonly related to the ‘frailty’ definition (SPPB, TUG, gait speed, handgrip strength)
 • Other relevant patient important outcomes – cognitive performance, functional performance, other measures of physical performance, quality of life, depression, self-perceived health, social engagement, caregiver burden, falls and fractures, mortality, hospitalisation, institutionalisation, comorbidity burden, drug prescription
Setting: Any (community, primary care, nursing homes, hospitals)
Perspective: Population
  1. GEM geriatric evaluation and management, GQ general question, Q question, SPPB short physical performance battery, TUG time up and go
  2. aThe provided list of interventions includes interventions evaluated in studies found in our systematic review [12] that did not match Q1 and Q2 definitions; it does not include any other possible intervention