Oral Presentation 6th Annual Scientific Meeting of the Australian and New Zealand Society for Sarcopenia and Frailty Research 2024

Remote Assessment and Management of Physical Function in Older Adults (RAMP): An International Modified Delphi Process to Develop Consumer Consensus (#13)

David Scott 1 , Christopher Hurst 2 , Jackson Fyfe 1 , Paul Jansons 1 , Eleanor Hayes 3 , Elsa Dent 4 , Gary Skinner 1 , Marc Sim 5 , Mylene Aubertin-Leheudre 6 , Sabine Britting 7 , Fanny Buckinx 6 , Gavin Connolly 8 , Ruth Dignam 9 , Lora Giangregorio 10 , Jennifer Jones 11 , Pauline Kelly 9 , Robert Kob 7 , Suzanne Morin 12 , Girish N 13 , Lucas Orssatto 1 , Maria Pearson 14 , Daniel Pinto 15 , Esmee M Reijnierse 16 , Catherine M Said 11 , Mohamed Salem 17 , Vina TS Sean 18 , Rosanna Tran 19 , Jesse Zanker 20 , Robin M Daly 1
  1. Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University
  2. AGE Research Group, Newcastle University, Newcastle upon Tyne, United Kingdom
  3. Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
  4. Torrens University Australia, Adelaide, Australia
  5. Nutrition & Health Innovation Research Institute, Edith Cowan University, Joondalup, Australia
  6. Département des Sciences de l'activité Physique, Université du Québec À Montréal, Montreal, Canada
  7. Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
  8. Metabolism and Healthy Aging Research Center (MHARC), Cedars-Sinai Medical Center, Los Angeles, United States
  9. IPAN Consumer Network, Deakin University, Burwood, Australia
  10. Schlegel-UW Research Institute for Aging, University of Waterloo, Waterloo, Canada
  11. Physiotherapy Department, The University of Melbourne, Parkville, Australia
  12. Department of Medicine, McGill University, Montreal, Canada
  13. Physiotherapy, Manipal Academy of Higher Education, Manipal, India
  14. School of Physical Education, Sport and Exercise Sciences, University of Otago, Otago, New Zealand
  15. Department of Physical Therapy, Marquette University, Milwaukee, United States
  16. Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
  17. Geriatrics, University of Malta, Valletta, Malta
  18. Exercise and Sports Science Programme, Universiti Sains Malaysia, Kelantan, Malaysia
  19. Rehabilitation and Aged Care Services, Northern Sydney Local Health District, Sydney, Australia
  20. Department of Medicine - Royal Melbourne Hospital, The University of Melbourne, Parkville, Australia

Background
Remote healthcare delivery has emerged as an effective tool for managing health outcomes, but its design and implementation often overlook the needs and preferences of older adults. The primary aim of this modified Delphi process was to develop consumer consensus on preferences for remote assessment and management of physical function.

 

Methods
Research experts (DS, CH, JF, PJ and RMD) co-developed the Round 1 Delphi survey with two consumer experts (RD and PK). This online survey was advertised to consumers (adults aged ≥60 years) via international clinical and research networks, and social media, between August and November 2023. The survey presented 23 Delphi statements for which consumers reported their level of agreement using an 11-point Likert scale (0-10; scores ≥7 indicated agreement). Statements were classified as having “strong agreement” and achieving consensus if ≥80% of consumers responded ≥7. Statements with “moderate” (70-80% of participants responded ≥7) or “low” agreement (<70% of participants responded ≥7) were revised by research experts, or rejected. Consumers were presented with the revised statements in Round 2 (January to February 2024).

 

Results

A total of 654 consumers (mean±SD age 69.0±6.0 years; 75.7% female) from 15 countries (five continents) provided complete responses in Round 1. Of 23 statements, 13 were accepted to have achieved consensus with the strongest agreement observed for statements relating to the importance of physical function for quality of life and performing activities of daily living (6 statements; agreement: 97.6-99.5%). Two statements regarding concerns about privacy and security when using technology (agreement: 20.8%) and inability to perform physical function assessments or exercise in the home (agreement: 15.5%) were rejected with low agreement. The remaining eight statements (agreement 49.5-79.5%) were revised into seven new statements, and 526 (80.4%) consumers from Round 1 provided complete responses in Round 2. Five of seven Round 2 statements were accepted with strong agreement (agreement: 80.0-82.7%), including the importance of addressing personal preferences for self- versus clinician-led remote interventions, and availability of necessary resources (e.g. technology and exercise equipment).

 

Conclusions
Consensus on 18 statements related to remote assessment and management of physical function indicates that older adults recognise physical function as a health priority, would value more information about it, and are willing to participate in remote assessment and management interventions (including via digital health) to maintain or improve it. The consensus statements reinforce that interventions should be easily accessible and address the varied personal preferences of consumers.