Screening for and Managing the Person with Frailty in Primary Care: ICFSR Consensus Guidelines

J. G. Ruiz; E. Dent; John E. Morley; R. A. Merchant; J. Beilby; J. Beard; C. Tripathy; M. Sorin; S. Andrieu; I. Aprahamian; H. Arai; M. Aubertin-Leheudre; J. M. Bauer; M. Cesari; L. K. Chen; A. J. Cruz-Jentoft; P. De Souto Barreto; B. Dong; L. Ferrucci; R. Fielding; L. Flicker; J. Lundy; J. Y. Reginster; L. Rodriguez-Mañas; Y. Rolland; A. M. Sanford; A. J. Sinclair; J. Viña; D. L. Waters; C. Won Won; J. Woo; B. Vellas

doi:10.1007/s12603-020-1492-3

Screening for and Managing the Person with Frailty in Primary Care: ICFSR Consensus Guidelines

J. G. Ruiz, E. Dent, John E. Morley, R. A. Merchant, J. Beilby, J. Beard, C. Tripathy, M. Sorin, S. Andrieu, I. Aprahamian, H. Arai, M. Aubertin-Leheudre, J. M. Bauer, M. Cesari, L. K. Chen, A. J. Cruz-Jentoft, P. De Souto Barreto, B. Dong, L. Ferrucci, R. FieldingL. Flicker, J. Lundy, J. Y. Reginster, L. Rodriguez-Mañas, Y. Rolland, A. M. Sanford, A. J. Sinclair, J. Viña, D. L. Waters, C. Won Won, J. Woo, B. Vellas

Internal Medicine

Research output: Contribution to journal › Article › peer-review

94 Citations (Scopus)

Abstract

Background

Cognitive behavior therapy (CBT) is effective for most patients with a social anxiety disorder (SAD) but a substantial proportion fails to remit. Experimental and clinical research suggests that enhancing CBT using imagery-based techniques could improve outcomes. It was hypothesized that imagery-enhanced CBT (IE-CBT) would be superior to verbally-based CBT (VB-CBT) on pre-registered outcomes.
Methods

A randomized controlled trial of IE-CBT v. VB-CBT for social anxiety was completed in a community mental health clinic setting. Participants were randomized to IE (n = 53) or VB (n = 54) CBT, with 1-month (primary end point) and 6-month follow-up assessments. Participants completed 12, 2-hour, weekly sessions of IE-CBT or VB-CBT plus 1-month follow-up.
Results

Intention to treat analyses showed very large within-treatment effect sizes on the social interaction anxiety at all time points (ds = 2.09–2.62), with no between-treatment differences on this outcome or clinician-rated severity [1-month OR = 1.45 (0.45, 4.62), p = 0.53; 6-month OR = 1.31 (0.42, 4.08), p = 0.65], SAD remission (1-month: IE = 61.04%, VB = 55.09%, p = 0.59); 6-month: IE = 58.73%, VB = 61.89%, p = 0.77), or secondary outcomes. Three adverse events were noted (substance abuse, n = 1 in IE-CBT; temporary increase in suicide risk, n = 1 in each condition, with one being withdrawn at 1-month follow-up).
Conclusions

Group IE-CBT and VB-CBT were safe and there were no significant differences in outcomes. Both treatments were associated with very large within-group effect sizes and the majority of patients remitted following treatment.

Original language	English
Journal	Journal of Nutrition, Health and Aging
DOIs	https://doi.org/10.1007/s12603-020-1492-3
Publication status	Published - 17 Oct 2020

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Ruiz, J. G., Dent, E., Morley, J. E., Merchant, R. A., Beilby, J., Beard, J., Tripathy, C., Sorin, M., Andrieu, S., Aprahamian, I., Arai, H., Aubertin-Leheudre, M., Bauer, J. M., Cesari, M., Chen, L. K., Cruz-Jentoft, A. J., De Souto Barreto, P., Dong, B., Ferrucci, L., ... Vellas, B. (2020). Screening for and Managing the Person with Frailty in Primary Care: ICFSR Consensus Guidelines. Journal of Nutrition, Health and Aging. https://doi.org/10.1007/s12603-020-1492-3

@article{50d4abaaeb934a10881badaf3573e9d3,

title = "Screening for and Managing the Person with Frailty in Primary Care: ICFSR Consensus Guidelines",

abstract = "BackgroundCognitive behavior therapy (CBT) is effective for most patients with a social anxiety disorder (SAD) but a substantial proportion fails to remit. Experimental and clinical research suggests that enhancing CBT using imagery-based techniques could improve outcomes. It was hypothesized that imagery-enhanced CBT (IE-CBT) would be superior to verbally-based CBT (VB-CBT) on pre-registered outcomes.MethodsA randomized controlled trial of IE-CBT v. VB-CBT for social anxiety was completed in a community mental health clinic setting. Participants were randomized to IE (n = 53) or VB (n = 54) CBT, with 1-month (primary end point) and 6-month follow-up assessments. Participants completed 12, 2-hour, weekly sessions of IE-CBT or VB-CBT plus 1-month follow-up.ResultsIntention to treat analyses showed very large within-treatment effect sizes on the social interaction anxiety at all time points (ds = 2.09–2.62), with no between-treatment differences on this outcome or clinician-rated severity [1-month OR = 1.45 (0.45, 4.62), p = 0.53; 6-month OR = 1.31 (0.42, 4.08), p = 0.65], SAD remission (1-month: IE = 61.04%, VB = 55.09%, p = 0.59); 6-month: IE = 58.73%, VB = 61.89%, p = 0.77), or secondary outcomes. Three adverse events were noted (substance abuse, n = 1 in IE-CBT; temporary increase in suicide risk, n = 1 in each condition, with one being withdrawn at 1-month follow-up).ConclusionsGroup IE-CBT and VB-CBT were safe and there were no significant differences in outcomes. Both treatments were associated with very large within-group effect sizes and the majority of patients remitted following treatment.",

keywords = "aging, Frailty, primary care",

author = "Ruiz, {J. G.} and E. Dent and Morley, {John E.} and Merchant, {R. A.} and J. Beilby and J. Beard and C. Tripathy and M. Sorin and S. Andrieu and I. Aprahamian and H. Arai and M. Aubertin-Leheudre and Bauer, {J. M.} and M. Cesari and Chen, {L. K.} and Cruz-Jentoft, {A. J.} and {De Souto Barreto}, P. and B. Dong and L. Ferrucci and R. Fielding and L. Flicker and J. Lundy and Reginster, {J. Y.} and L. Rodriguez-Ma{\~n}as and Y. Rolland and Sanford, {A. M.} and Sinclair, {A. J.} and J. Vi{\~n}a and Waters, {D. L.} and {Won Won}, C. and J. Woo and B. Vellas",

year = "2020",

month = oct,

day = "17",

doi = "10.1007/s12603-020-1492-3",

language = "English",

journal = "Journal of Nutrition, Health and Aging",

issn = "1279-7707",

publisher = "SPRINGER FRANCE",

}

Ruiz, JG, Dent, E, Morley, JE, Merchant, RA, Beilby, J, Beard, J, Tripathy, C, Sorin, M, Andrieu, S, Aprahamian, I, Arai, H, Aubertin-Leheudre, M, Bauer, JM, Cesari, M, Chen, LK, Cruz-Jentoft, AJ, De Souto Barreto, P, Dong, B, Ferrucci, L, Fielding, R, Flicker, L, Lundy, J, Reginster, JY, Rodriguez-Mañas, L, Rolland, Y, Sanford, AM, Sinclair, AJ, Viña, J, Waters, DL, Won Won, C, Woo, J & Vellas, B 2020, 'Screening for and Managing the Person with Frailty in Primary Care: ICFSR Consensus Guidelines', Journal of Nutrition, Health and Aging. https://doi.org/10.1007/s12603-020-1492-3

TY - JOUR

T1 - Screening for and Managing the Person with Frailty in Primary Care

T2 - ICFSR Consensus Guidelines

AU - Ruiz, J. G.

AU - Dent, E.

AU - Morley, John E.

AU - Merchant, R. A.

AU - Beilby, J.

AU - Beard, J.

AU - Tripathy, C.

AU - Sorin, M.

AU - Andrieu, S.

AU - Aprahamian, I.

AU - Arai, H.

AU - Aubertin-Leheudre, M.

AU - Bauer, J. M.

AU - Cesari, M.

AU - Chen, L. K.

AU - Cruz-Jentoft, A. J.

AU - De Souto Barreto, P.

AU - Dong, B.

AU - Ferrucci, L.

AU - Fielding, R.

AU - Flicker, L.

AU - Lundy, J.

AU - Reginster, J. Y.

AU - Rodriguez-Mañas, L.

AU - Rolland, Y.

AU - Sanford, A. M.

AU - Sinclair, A. J.

AU - Viña, J.

AU - Waters, D. L.

AU - Won Won, C.

AU - Woo, J.

AU - Vellas, B.

PY - 2020/10/17

Y1 - 2020/10/17

N2 - BackgroundCognitive behavior therapy (CBT) is effective for most patients with a social anxiety disorder (SAD) but a substantial proportion fails to remit. Experimental and clinical research suggests that enhancing CBT using imagery-based techniques could improve outcomes. It was hypothesized that imagery-enhanced CBT (IE-CBT) would be superior to verbally-based CBT (VB-CBT) on pre-registered outcomes.MethodsA randomized controlled trial of IE-CBT v. VB-CBT for social anxiety was completed in a community mental health clinic setting. Participants were randomized to IE (n = 53) or VB (n = 54) CBT, with 1-month (primary end point) and 6-month follow-up assessments. Participants completed 12, 2-hour, weekly sessions of IE-CBT or VB-CBT plus 1-month follow-up.ResultsIntention to treat analyses showed very large within-treatment effect sizes on the social interaction anxiety at all time points (ds = 2.09–2.62), with no between-treatment differences on this outcome or clinician-rated severity [1-month OR = 1.45 (0.45, 4.62), p = 0.53; 6-month OR = 1.31 (0.42, 4.08), p = 0.65], SAD remission (1-month: IE = 61.04%, VB = 55.09%, p = 0.59); 6-month: IE = 58.73%, VB = 61.89%, p = 0.77), or secondary outcomes. Three adverse events were noted (substance abuse, n = 1 in IE-CBT; temporary increase in suicide risk, n = 1 in each condition, with one being withdrawn at 1-month follow-up).ConclusionsGroup IE-CBT and VB-CBT were safe and there were no significant differences in outcomes. Both treatments were associated with very large within-group effect sizes and the majority of patients remitted following treatment.

AB - BackgroundCognitive behavior therapy (CBT) is effective for most patients with a social anxiety disorder (SAD) but a substantial proportion fails to remit. Experimental and clinical research suggests that enhancing CBT using imagery-based techniques could improve outcomes. It was hypothesized that imagery-enhanced CBT (IE-CBT) would be superior to verbally-based CBT (VB-CBT) on pre-registered outcomes.MethodsA randomized controlled trial of IE-CBT v. VB-CBT for social anxiety was completed in a community mental health clinic setting. Participants were randomized to IE (n = 53) or VB (n = 54) CBT, with 1-month (primary end point) and 6-month follow-up assessments. Participants completed 12, 2-hour, weekly sessions of IE-CBT or VB-CBT plus 1-month follow-up.ResultsIntention to treat analyses showed very large within-treatment effect sizes on the social interaction anxiety at all time points (ds = 2.09–2.62), with no between-treatment differences on this outcome or clinician-rated severity [1-month OR = 1.45 (0.45, 4.62), p = 0.53; 6-month OR = 1.31 (0.42, 4.08), p = 0.65], SAD remission (1-month: IE = 61.04%, VB = 55.09%, p = 0.59); 6-month: IE = 58.73%, VB = 61.89%, p = 0.77), or secondary outcomes. Three adverse events were noted (substance abuse, n = 1 in IE-CBT; temporary increase in suicide risk, n = 1 in each condition, with one being withdrawn at 1-month follow-up).ConclusionsGroup IE-CBT and VB-CBT were safe and there were no significant differences in outcomes. Both treatments were associated with very large within-group effect sizes and the majority of patients remitted following treatment.

KW - aging

KW - Frailty

KW - primary care

UR - http://www.scopus.com/inward/record.url?scp=85092689380&partnerID=8YFLogxK

U2 - 10.1007/s12603-020-1492-3

DO - 10.1007/s12603-020-1492-3

M3 - Article

C2 - 33155616

AN - SCOPUS:85092689380

SN - 1279-7707

JO - Journal of Nutrition, Health and Aging

JF - Journal of Nutrition, Health and Aging

ER -

Screening for and Managing the Person with Frailty in Primary Care: ICFSR Consensus Guidelines

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