Objective 1: Understand frailty and its relation to health outcomes and costs to society
The FOCUS Project is synthesizing existing published evidence on frailty screening and management from around the world. A systematic review of the effectiveness of the interventions in preventing the progression of pre-frailty and frailty in older adults has been produced and will soon be sent out for publication. Thousands of studies published in English, Portuguese, Spanish, Italian and Dutch were considered for inclusion. An umbrella review on the capacity of available frailty screening tools to predict risk and outcomes for frail older adults, synthesizing knowledge from previous reviews, has been published on the JBI Database of Systematic Reviews and Implementation Reports.
Objective 2: Understand the needs of those involved in the frame of frailty
The perspectives of those involved in the frame of frailty, as patients and their families, health and social care providers and informal caregivers are of paramount importance. The FOCUS consortium has adopted a two-side strategy to deal with this complex subject. A meta-synthesis of qualitative studies on stakeholders’ views and experiences of care and interventions addressing frailty and pre-frailty has been conducted, focusing on understanding, beliefs and attitudes of those involved towards screening, intervention and care. Three electronic databases were searched to identify relevant papers: PubMed, CINHAL and Web of Science. In addition, the FOCUS Consortium run a number of semi-structured focus group and individual interviews in Italy, Poland and the UK with frail and non-frail older adults, family caregivers, and health and social care professionals.
Objective 3: Analyze and depict the work being done in Europe regarding the frailty syndrome.
Frailty is one of the greatest challenges for societies faced with ageing populations, as frail older adults are high users of informal and formal care and healthcare services. Such is the case in the European Union, where the proportion of the population aged 65 years and over is predicted to rise from 18.5% in 2010 to 28.7% in 2060. To tackle the situation, the EIPAHA (European Innovation Partnership on Active Healthy Ageing) has been launched, gathering partners committed with research and field work aiming at preventing or reversing frailty condition in old age. The FOCUS project set out an initiative to categorize the EIPAHA commitments and implemented a structures survey of EIPAHA partners, in order to synthesise and share learning experiences from EIPAHA frailty commitments that are active over Europe.
Objective 4: Identify targets for customized strategies aimed at large-scale adoption of good practices in frailty management
The FOCUS project will deploy a set of indicators to assess interventions on frailty in old age. The indicators will be used in the analytical characterization and comparison of interventions within the EIPAHA in the areas of screening and primary prevention of pre-frailty/frailty, and secondary prevention/management of frailty. The project will explore the relationships between indicators, and between them and the organizational, economic, social context in order to identify possible targets for optimisation strategies. Predictive models of resource consumption and health and social care costs will be generated. The use of comparative effectiveness research will allow to draw conclusions regarding the most adequate and customized approach to assist EIPAHA commitments in achieving success. Inequalities, cultural conditions or cross-border issues will be considered as representative of the diversity in Europe.
Objective 5: Activate the FOCUS Network in Europe supported by an online cooperative platform
The FOCUS project will bring together representatives of the identified stakeholders in a network of people and organizations committed to research or field work aiming at optimizing the care of frail old citizens. Members of the FOCUS Network will collaborate with the FOCUS Consortium on the validation of the set of indicators to assess interventions on frailty, the definition of requisites for the online Platform for Knowledge Exchange and the test of the FOCUS guidelines. The final goal is to constitute them as privileged agents for the dissemination of the FOCUS methods and results and the scale-up of its activities in Europe, accelerating the accrue of benefits for patients and their families, care providers and society at large.
Objective 6: Deploy recommendations as customized services for health professionals and senior citizens
The FOCUS project will develop and deploy guidelines as services tailored to the particular conditions and needs of care professionals and senior citizens over Europe. The aim is to provide support during the implementation of interventions on frailty, help optimizing the effort and promote scalability. The Consortium will run pilots to test the usability and performance of the guidelines in real EIPAHA commitments.
Objective 7: Develop a platform for personalized training, guidance, help and education to older people and those caring for them.
The FOCUS project will deploy online platforms to foster and support the exchange of knowledge between those involved in interventions on frailty and to help scaling-up the methods and results of good practices in Europe.