Evidence of and recommendations for non-pharmacological interventions for common geriatric conditions: The SENATOR-ONTOP systematic review protocol

Abstract

Introduction: Non-pharmacological therapies for common chronic medical conditions in older patients are underused in clinical practice. We propose a protocol for the assessment of the evidence of nonpharmacological interventions to prevent or treat relevant outcomes in several prevalent geriatric conditions in order to provide recommendations. Methods and analysis: The conditions of interest for which the evidence about efficacy of nonpharmacological interventions will be searched include delirium, falls, pressure sores, urinary incontinence, dementia, heart failure, orthostatic hypotension, sarcopaenia and stroke. For each condition, the following steps will be undertaken: (A) prioritising clinical questions; (B) retrieving the evidence (MEDLINE, the Cochrane Library, CINAHL and PsychINFO will be searched to identify systematic reviews); (C) assessing the methodological quality of the evidence (risk of bias according to the Cochrane method will be applied to the primary studies retrieved from the systematic reviews); (D) developing recommendations based on the evidence (Grading of Recommendations Assessment, Development and Evaluation (GRADE) items - risk of bias, imprecision, inconsistency, indirectness and publication bias - will be used to rate the overall evidence and develop recommendations). Dissemination: For each target condition, at least one systematic overview concerning the evidence of non-pharmacological interventions will be produced and published in peer-reviewed journals.