预防和管理衰弱的临床实践指南：系统评价

Abstract

Aims

To systematically search for clinical practice guidelines focusing on the prevention and management of frailty, to evaluate their methodological quality and to synthesize the consensus recommendations.

Design

A systematic review.

Data Sources

Guideline websites, related professional association websites and electronic databases were systematically searched through 4 November 2020.

Review Methods

We evaluated the methodological quality of the eligible guidelines using the Appraisal of Guidelines Research and Evaluation II (AGREE II). Two reviewers synthesized the consensus recommendations proposed by at least two guidelines.

Results

Eight guidelines met the eligibility criteria and were included in the review. The mean scores of the six domains were as follows: the ‘scope and purpose’ domain scored 88.0%, the ‘clarity of presentation’ domain scored 81.9%, the ‘stakeholder involvement’ domain scored 63.4%, the ‘editorial independence’ domain scored 62.2%, the ‘rigour of development’ domain scored 61.1% and the ‘applicability’ domain scored 57.8%. In total, we synthesized 23 recommendations for the prevention and management of frailty that are consistent among the included guidelines.

Conclusions

The number of clinical practice guidelines for the prevention and management of frailty is limited. The methodological quality of existing guidelines needs to be improved. Our synthesized findings provide an intuitive, convenient and summative reference resource for frailty prevention and management. It’ is worth noting that recommendations described in the included guidelines require additional detail.

Impact

Although the prevention and management of frailty is urgent, there is currently a lack of evidences guiding these processes, especially in the prevention. The methodological quality of existing guidelines is insufficient, and the recommendations described in the guidelines require additional detail. Therefore, users of these guidelines, especially nurses, should make a careful decision according to the specific situation when using. Nurses also have a key role in providing more clinical evidences for the improvement of the quality of the guidelines.

摘要翻译（仅供参考）

宗旨

系统地搜索以预防和管理衰弱为重点的临床实践指南，评估其方法学质量并综合共识建议。

设计

系统评价。

数据源

截至 2020 年 11 月 4 日，系统搜索了指南网站、相关专业协会网站和电子数据库。

复习方法

我们使用指南研究和评估评估 II (AGREE II) 评估了合格指南的方法学质量。两名评审员综合了至少两个指南提出的共识建议。

结果

八项指南符合资格标准并被纳入审查。六个领域的平均得分如下：“范围和目的”领域得分为 88.0%，“表述的清晰度”领域得分为 81.9%，“利益相关者参与”领域得分为 63.4%，“编辑独立性”领域得分为62.2%，“发展的严谨性”领域得分为 61.1%，“适用性”领域得分为 57.8%。总的来说，我们综合了 23 条预防和管理虚弱的建议，这些建议在所包含的指南中是一致的。

结论

预防和管理衰弱的临床实践指南数量有限。现有指南的方法学质量需要改进。我们的综合研究结果为衰弱的预防和管理提供了直观、方便和总结性的参考资源。值得注意的是，包含的指南中描述的建议需要额外的细节。

影响

尽管衰弱的预防和管理迫在眉睫，但目前缺乏指导这些过程的证据，特别是在预防方面。现有指南的方法学质量不足，指南中描述的建议需要额外的细节。因此，这些指南的使用者，尤其是护士，在使用时应根据具体情况慎重决定。护士在为提高指南质量提供更多临床证据方面也发挥着关键作用。