Abstract
Introduction:
The need to develop and evaluate frailty-related interventions is becoming more pertinent as life expectancy increases. Patient-reported outcome measures (PROMs) are arguably essential in this field of research, and can be defined as “any report of the status of a patient's health condition that comes directly from the patient, without interpretation of the patient's response by a clinician or anyone else” (FDA 2009). Numerous validated questionnaires can be classed as PROMs, but seem inconsistently used, and of uncertain relevance to/for those living with frailty. This rapid review aimed to identify existing PROMs used in research with older people living with frailty.
Method:
PubMed and Cochrane were searched (up to 24/11/22). Inclusion criteria were quantitative studies, use of a PROM, and either measurement of frailty or inclusion of older adults as participants. Distinguishing PROMs from questionnaire-based clinical assessments was necessary, and criteria were created to do this. 197 records were screened. PROMs were categorised according to the domain they assess, based on a standard set of health outcome measures for older people (Akpan et al, 2018).
Results:
90 studies were included. 119 unique PROMs were used 289 times, most frequently the SF-36 (n=23), EQ-5D (n=21) and Barthel Index (n=14). The most frequently assessed outcome domains included “Mood and Emotional Health”, and “Activities of Daily Living”. Outcome domains with fewer usages included “Participation in Decision Making” and “Carer Burden”.
Conclusions:
PROM usage in frailty research is highly heterogeneous. The most frequently used PROMs omit outcomes that are important to people with frailty (e.g. Akpan et al 2018, Herrler et al 2021, Mayo et al 2022). Further research should investigate the importance of specific outcomes (and thus identify particularly relevant PROMs) to people living at different stages of frailty severity. More consistency of PROM use could facilitate evaluation of different frailty interventions.