Core outcome set relevant to (physical rehabilitation with) frail older people (in care homes)

Frailty is an important concept in elderly care. Broadly, it defines those that are most vulnerable to poor outcomes such as increasing disability and mortality. Frail elderly people are less able to recover successfully from the effects of stressors because of reduced capacity in multiple systems, so that health events that are typically considered minor can have serious and lasting consequences.

This project aims to develop a core outcome set relevant to frail older people. The scope may be restricted to physical rehabilitation interventions. This work follows our Cochrane review of physical rehabilitation for older people in long-term care. In this, no single outcome domain was reported by half of the included studies. This research aims to (i) identify the outcome domains currently used in frailty research. (ii) Identify the domains that frail elderly people and other stakeholders consider most important. (iii) Examine whether there are conflicting perceptions within and between stakeholder groups. (iv) Derive a set of core outcomes for frailty if appropriate.


Anne Forster (PI), John Young, Lesley Brown, Tom Crocker, David Clarke, Andrew Clegg:
Academic Unit of Elderly Care and Rehabilitation, Bradford Institute of Health Research, Bradford Teaching Hospitals NHS Foundation Trust

Further Study Information

Current Stage: Planning
Funding source(s): Not yet known

Health Area

Disease Category: Health care of older people

Disease Name:

Target Population

Age Range: 65 - 100

Sex: Either

Nature of Intervention:

Stakeholders Involved

- Clinical experts
- Consumers (caregivers)
- Consumers (patients)
- Families
- Regulatory agency representatives
- Researchers
- Service commissioners
- Service providers

Study Type

- COS for clinical trials or clinical research


- Delphi process
- Focus group(s)
- Interview
- Literature review

The initial work will include core outcome set development, without specifying particular measurement tools. We will undertake literature reviews to identify domains used in the current trial literature and domains important to the frail elderly (qualitative literature). Depending upon the extent and scope of the existing knowledge, we will supplement this with semi-structured interviews and focus groups, as appropriate to the stakeholder group. The data will be analysed using a grounded theory approach with constant comparison. We will probably use a modified Delphi process and structure deliberation as part of the process for eliciting opinion on the degree of importance of different domains and for gaining consensus. We also intend to use Q-Methodology to elicit opinion, which we believe will be more appropriate to our proposed client group and will help to establish the degree of consensus (or otherwise).

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