Nutri rition a and Ac Activity ty Clinical Practi ctice - - PowerPoint PPT Presentation

Nutri rition a and Ac Activity ty Clinical Practi ctice Guideline for O r Older r Ad Adults Livi ving w with F Frailty

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Jayna Holroyd-Leduc, MD FRCPC

Chair, CFN KT Committee Head and Professor, Div. of Geriatric Medicine, U of Calgary

CP CPG: St Steer eerin ing Co Commit ittee e

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• Jayna Holroyd-Leduc (University of Calgary)
• John Muscedere (Queens University)
• Anik Giguere (Laval University)
• Leah Gramlich (University of Alberta)
• Heather Keller (University of Waterloo)
• Ada Tang (McMaster University)
• Danielle Bouchard (University of New Brunswick)
• Amanda Lorbergs (CFN)

CPG: Evidence Rev eview w

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• Partnered with MERST (McMaster Evidence Review

and Synthesis Team)

• Topic areas refined
• 2 separate reviews
• PICOS
• Search strategy
• Peer review of PICOS and search strategy
• Protocols registered with PROSPERO
• Follow PRISMA (Preferred Reporting Items for Systematic

Reviews and Meta-Analyses) statement

• GRADE quality analysis

CPG PG: Nutri rition Revi view

• QUESTION: What is the effectiveness of nutritional interventions on older

adults (age 65+) living with frailty or pre-frailty on outcomes? What are the associated harms?

• Databases Search: MEDLINE, Embase, Cochrane databases
• Search results: 3158 citations; 119 full text
• P (population): adults 65+ with frailty/pre-frailty
• I (intervention): any nutrition intervention
• C (control): any comparison group
• O (outcomes): body weight, frailty, function, grip strength, sarcopenia, QoL,

LTC admission, hospital LOS, hospital admission, mobility, diet quality, caregiver social support, harms

• S (study design): RCT, quasi-experimental trials, observational cohorts with

comparison group

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CPG PG: Ph Physical Ac Activi vity R Revi view

• QUESTION: What is the effectiveness of physical activity interventions on
• lder adults (age 65+) living with frailty or pre-frailty on outcomes? What

are the associated harms?

• Databases Searched: MEDLINE, Embase, Cochrane databases
• Search results: 4709 citations; 283 full text
• P (population): adults 65+ with frailty/pre-frailty
• I (intervention): any physical activity intervention
• C (control): any comparison group
• O (outcomes): mobility, fall incidence or fall rate (total, injurious), QoL,

function, muscle strength or power, physical activity level, mood, LTC admissions, hospital admissions, hospital LOS, caregiver burden, harms

• S (study design): RCT, quasi-experimental trials, observational cohorts with

comparison group

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CPG: Gu Guidel eline e Devel elop

• pmen

ent Proc

• ces

ess

• Develop Guideline Consensus Panel
• Engaging appropriate stakeholders, organizations and content

experts

• Review quality and strength of evidence
• GRADE (Grading of Recommendations Assessment, Development

and Evaluation) assessment

• Develop evidence statements
• Develop recommendations and strength statements
• Develop Clinical Practice Guideline (CPG)
• Peer review of CPG
• Develop KT plan (activities and tools)
• Dissemination; Knowledge transfer and exchange initiatives

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CPG: G: T Timel eline, Deliver erables les, a and M Miles eston

• nes

2 0 1 9 2 0 2 0

• Topic refinement
• Protocol development
• Identification of key stakeholders
• Solicit interest of end-users in CPGs

development and dissemination

• Protocol registration
• Literature search
• Citation screening
• Data extraction
• Statistical analysis

(including GRADE analysis)

• Evidence synthesis

March 2020 Submit systematic reviews to peer-reviewed journal(s) April 2020: Consensus Panel meeting Assess level of certainty in evidence Draft recommendation and strength statements September 2020

• CPGs published *
• Begin widespread

dissemination and implementation

• Submit CPGs to

peer-reviewed journal(s)

Inter eres ested ed in becom

• ming i

g invol

• lved

ed?

• Consensus Panel Meeting (April 29 in Calgary)
• Dissemination and Knowledge Transfer and

Exchange Activities

• CONTACT: Amanda Lorbergs

amanda@cfn-nce.ca

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