Core domains for research on hospital inactivity in acutely ill older adults: a Delphi consensus study.

ABSTRACT Objective To identify core domains for research studies of physical activity (PA) and sedentary behaviour (SB) during hospitalisation for older adults with an acute medical illness. Design A 4-Round Delphi consensus process. Round 1 invited responses to open-ended questions to generate items for the core domains research. In Rounds 2-4, participants were invited to use a Likert scale (1-9) to rate the importance of each core domain for research studies of PA/SB in hospitalised older adults with an acute medical illness. Setting Online surveys. Participants 49 participants were invited to each round (international researchers, clinicians, policy makers and patients). Response rates across Rounds 1-4 were 94%, 88%, 83% and 81% respectively. Interventions None. Main Outcome Measures Consensus was defined a priori as: ≥70% of respondents rating an item as “critical” (score ≥7) and ≤15% of respondents rating an item as “not important” (score ≤3). Results In Round 2, 9/25 core domains reached consensus agreement (physical functioning, general, role functioning, emotional functioning, global quality of life, hospital, psychiatric, cognitive functioning and carer burden). In Round 3, an additional eight reached consensus (adverse events, perceived health status, musculoskeletal, social functioning, vascular, cardiac, mortality and economic). Round 4 participants provided further review and a final rating of all 17 core domains that met consensus in previous rounds. Four core domains were rated as ‘critically important’ to evaluate: physical functioning, social functioning, emotional functioning and hospital outcomes. Conclusions This preliminary work provides international and expert consensus-based core domains for development towards a core-outcome set for research, with the ultimate goal of fostering consistency in outcomes/reporting to accelerate research on effective strategies to address PA/SB in older adults while hospitalised.