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A systematic review and recommendations for prom instruments for older people with frailty in emergency care.

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posted on 2022-11-09, 10:34 authored by James David van Oppen, Abdullah Alshibani, Timothy John Coats, Blair Graham, Patricia Holch, Jagruti Lalseta, Nicola Mackintosh, Vivien Richardson, Peter Riley, Jose M Valderas, Simon Paul Conroy

The current service metrics used to evaluate quality in emergency care do not account for specific healthcare outcome goals for older people living with frailty. These have previously been classified under themes of 'Autonomy' and 'Functioning'. There is no person-reported outcome measure (PROM) for older people with frailty and emergency care needs. This study aimed to identify and co-produce recommendations for instruments potentially suitable for use in this population.In this systematic review, we searched six databases for PROMs used between 2010 and 2021 by older people living with frailty receiving acute hospital care. Studies were reviewed against predefined eligibility criteria and appraised for quality using the COSMIN Risk of Bias checklist. Data were extracted to map instrument constructs against an existing framework of acute healthcare outcome goals. Instrument face and content validity were assessed by lay collaborators. Recommendations for instruments with potential emergency care suitability were formed through co-production.Of 9392 unique citations screened, we appraised the full texts of 158 studies. Nine studies were identified, evaluating nine PROMs. Quality of included studies ranged from 'doubtful' to 'very good'. Most instruments had strong evidence for measurement properties. PROMs mainly assessed 'Functioning' constructs, with limited coverage of 'Autonomy'. Five instruments were considered too burdensome for the emergency care setting or too specific for older people living with frailty.Four PROMs were recommended as potentially suitable for further validation with older people with frailty and emergency care needs: COOP/WONCA charts, EuroQol, McGill Quality of Life (Expanded), and Palliative care Outcome Scale.

Funding

This study was supported by the National Institute for Health Research (Doctoral Research Fellowship NIHR300901 – salary for JDvO) and by the British Medical Association Foundation for Medical Research (Lift Into Research – lay collaborator engagement expenses).

History

Citation

van Oppen, J.D., Alshibani, A., Coats, T.J. et al. A systematic review and recommendations for prom instruments for older people with frailty in emergency care. J Patient Rep Outcomes 6, 30 (2022). https://doi.org/10.1186/s41687-022-00438-x

Author affiliation

Department of Health Sciences

Version

  • VoR (Version of Record)

Published in

Journal of patient-reported outcomes

Volume

6

Issue

1

Pagination

30

Publisher

SpringerOpen

issn

2509-8020

eissn

2509-8020

Acceptance date

2022-03-18

Copyright date

2021

Available date

2022-04-01

Spatial coverage

Germany

Language

eng

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