Frailty and functional decline both physical and cognitive
Minutes 6th Meeting
Charlemagne Building, Rue de la Loi 170
Brussels, 5 March, 2014
FINAL( approved by participants)
Summary
The 6th meeting of the Action Group on Frailty (A3) took place in Brussels on the 5th of March, and was chaired by the European Commission (EC) following the approved agenda (annex 1).
Attending participants (annex 2):
· Were informed about the 2014 Work plan, AG structure and roadmap
· Were invited to present their work on the collaborative tasks per subgroup.
· Were informed on the results on the individual commitments follow-up ,
· Were asked to discuss in their subgroups what deliverables and information they might showcase in the upcoming events and visibility tools (such as the eHealth Forum in Athens or a info-graphic leaflet)
· Were informed on the outcomes of the monitoring, an encouraged to fill in the monitoring forms before the 17th of March if they had not already done so.
· Were informed on communication work foreseen by the EC communication Unit to give visibility to EIP results and activities.
Presentation of the agenda (EC)
Jorge Pinto Antunes, European Commission (JPA) welcomed and thanked all participants for their attendance. He highlighted the ambitions of the year and the work that is to be done. 2014 is a year of consolidation of the work and of delivering tangible results. A new college of commissioners will take over at the end of the year and we need to present to them convincing results .
He presented the agenda (annex 1) and the main aims of the meeting. No further issues were included by participants and the meeting move on as scheduled.
Work plan, structure and the roadmap (EC) & Partners
Ines Garcia Sanchez, European Commission (IGS) presented the work plan, structure and roadmap of A3 common work. A PPT is provided (annex 3)
IGS explained that work under the Action Group (AG) will be conducted in 2 tracks an individual commitment track – drawing on the commitments that A3 EIP partners submitted on the occasion of the 1st and 2nd invitation for commitment – and a second track initiated more recently on common work – drawing on the willingness and interest shown by some of the A3 partners to conduct collaborative work in addition to the individual commitments.
Furthermore, she explained the structure of the 6 different subgroups and how individual commitments fit into these sub-groups. Each of the 6 sub-groups have their own coordinator. The common tasks have a facilitator to aid in the dynamics of the work and follow-up of expected deadlines and results. They will report to the sub-group coordinator. TTwo changes were announced: The Nutrition coordinator Frank de Man has stepped down, and is replaced by Maddalena Illario. The coordinator for the Physical activity subgroup, Miriam Vollenbroek-Hutten has stepped down too, and is replaced by Miren David.
Then the subgroup coordinators informed on how each of the subgroups had been working since the Coordinators meeting held last January. They referred to the main tasks that will be addressed by the partners and to the achievements so far.
Antonio Cano, coordinator for Subgroup Cognitive Decline (CD)
· Review of the CD concepts (for Nov. 2014)
· Technology and screening (for Dec. 2014)
· Update on the monitoring of the main forms of CD (for Nov. 2014)
· Analysis of the datasets (for April 2015)
· Reduction of the CD strategies (for Dec. 2014)
· Development of a PhD program in Ageing (for June 2015)
Madallena Illario, coordinator for Subgroup on Nutrition (N):
· The assessment of N as a risk factor (for Dec. 2015)
· Knowledge generation of functional foods (for June 2017)
· A culinary approach to N (for June 2015)
· Nutritional Intervention (for Oct. 2017)
· The provision of information to, and empowerment of, targets groups (for Dec. 2015)
· The development of innovative biomarkers for metabolism (for Dec. 2016)
William Molloy, coordinator Subgroup Care Givers (CG):
· The development of a screening tool that show risk for nursing home, hospital and death.
· They have been screening a high number of patients the different countries involved.
·
Roberto Bernabei, Subgroup Functional Decline (FD);
· Apologizes because the group has not been very active, one reason being that he himself and other partners were heavily involved in the IMI call on the prevention of frailty.
· The development of geriatric assessment tools.
· A quality of life assessment.
· The development of innovative biomarkers on FD.
· The exploration of ICT options regarding FD.
Marta Castro, on behalf of Leocadio Rodriguez, Coordinator for Subgroup Frailty in General (FG)
· Mapping/screening tools for frailty (for March 2014)
· The integration of health and service pathways (for April 2014)
· Education and training (for April 2014)
· The outlining of research gaps and priorities (for Sept. 2014)
Miriam Vollenbroek , former coordinator for Subgroup Physical Activity (AC)
· Screening of PA (for July 2014)
· Monitoring in the community (for July 2014)
· The management of frailty by PA (for July 2014, and updated over time)
· Large number of partners involved in the sub-group.
Individual commitments overview (EC)
Anna Carta, European Commission (AC) gave an overview of the response by the partners to the EC follow up of the individual commitments about the state of play in the implementation process.
She remembered that the follow-up of individual commitments is the responsibility of EC and explained the work carried out during the last months to monitor/clarify the detail of partners commitments and to map the list of expected deliverables from the individual commitments. The information collected is summarised by:
In total 86 responses out of 134 were received. Three groups were identified within the response. 73 commitments are currently active, have produced and defined deliverables and have a defined roadmap for the future. 6 projects have vaguely described deliverables and are on hold for the moment. In total 7 commitments did not commence from the initial commitment. These groups are only contributing to the common work. In 2014, 54 partners are expected to present deliverables.
AC continued by giving an overview of the A3 roadmap and upcoming events (annex 3). She presented the roadmap for 2014 which highlights the milestones for A3 AG activities and those common to all AGs such as monitoring or EIP events.
(annex 4)
Working groups (All)
Before breaking for lunch, the different subgroups were asked to discuss the deliverables and information that they would like to showcase in future events, including the upcoming e-Health Forum week in Athens. They were also asked to brainstorm about the content and form of an A3 info graphic. A guideline with some bullet points to stimulate discussion was distributed. (annex 5)
Groups reporting back to the audience (Coordinators)
After lunch the coordinators were asked to give a short overview of what was discussed in the working group sessions:
Antonio Cano, Subgroup Cognitive Decline:
·
· High heterogeneity of partners that make work complex, but also tangible rewards for being involved in the EIP. Although somehow slow we hope we have made some progress and more is foreseen.
· The status of the commitments and common work was discussed. The question was raised if the good practice book could be updated to include commitments. They all started the common work in February and not much had been achieved yet but some steps have been taken.
· In the coming events it is important to highlight that A3 differentiation is more than just frailty. The presentation of the results in these events depends on the running speed of the different projects. The use of technology and a screen with the commitments and good practices may help show how these are connected to e-Health.
· For the info graphic the advice was to be simple and clear. A suggestion was a “cloud of keywords/activities “ which can be clicked for more in depth information. An info graphic in the shape of a brain was also suggested.
Madalena Illario, Subgroup Nutrition:
· They have agreed on a common vision. They would be interested in advancing a position paper to show case in events.
· Several results are ready to scale-up: screening; innovative foods supplements; ICT tools..
· In future papers, conferences and the e-Health event the subgroup would like to showcase their scaling up of the assessments, extended screening for assisted living, and research on food supplements. Another interesting topic for these events might be the evidence and a practical example on the intervention on the culinary approach.
· The key information for their group is that of the nutrition pyramid. The most important attention point for the info graphic is to make sure to avoid misunderstanding and silos work.
· They have liked the idea of the “ cloud” presented before, could work on something similar.
Roberto Bernabei, Subgroup Functional Decline:
· A booklet will be made on the different tools that are collected to measure frailty. At the events they would like to present this, as well as the deliverable from the commitments. The goal of these presentations would be to increase awareness, and close the gaps between knowledge and determinants.
Miren David, Subgroup Physical Activity:
· The work plan of the deliverables within the common work was discussed. In July 2014, three reports on these results on each of the 3 tasks (screening, monitoring and management) will be presented.
William Molloy, Subgroup Care givers
· The developments in the screening tool that is part of the common work were further discussed, and the next steps were determined.
· They are about to publish an article with these results. No other comments for visibility of results.
Marta Castro, Subgroup Frailty in General
• A booklet will be made on the different tools that are collected to measure frailty, to be ready by the conference of partners.
• At the eHealth events they would like to present the commitments with a series of statements. These statements are related to the four tasks of the subgroup:
o Measure Frailty
o Target intervention
o increase awareness,
o close the gaps in knowledge on the determinants of frailty.
Conference on frailty (EC)
IGS presented key information on the Conference on Frailty on the 18th of June. A maximum of 120 participants will be invited including both partners and external stakeholders. The Conference will consist of plenary sessions with keynote speakers addressing the priorities of frailty and three parallel workshops focused on working towards a EU policy on frailty. The program and subscription possibilities will be circulated on Yammer in due time.
Summing-up and key ideas before information on specific topics is given (EC) .
JPA highlighted the following points to be considered by stakeholders interested in the EIP and all A3 partners. The EIP and the AG meetings are not a discussion forum. What we are committing to has been stressed from the beginning, there is no room now for discussing other possibilities of structuring the work, of revisiting concepts etc. Partners should reconsider their role if they have no possibility to fulfil their EIP commitment.
· Some partners are very committed and following on what they said they would be doing; unfortunately a number of others are not living to it. No evaluation of the group is foreseen but the results of those really committed will be more and more reflected in the AG work and will be given greater visibility whenever possible.
· Though no budget was allocated to the EIP the EC has managed to identify ageing as a priority in the EC financial instruments and give visibility-politically speaking and in different events- to “frailty”.
· EC needs feed-back from the stakeholders it is working with, but in some aspects the results so far are lagging behind.
The ambition for 2014 is high and this requires a lot from everyone; if frailty is to become an important issue on the agenda, we need to demonstrate tangible results. Politically, it is important to show to the new College of Commissioners the achievements from this new partnership model.
Monitoring (EC)
Marianne van den Berg, European Commission (MvB) gave an introduction on the monitoring process of the EIP for AHA. Both the process and the outcomes are monitored to illustrate the added value of the EIP. The EIP can help overcome barriers such as the lack of evidence. By clustering the same types of interventions and indicators within the Partnership the results can be compared to create more evidence for the observed trends. A framework has been developed and improved with the information form the reference sites, good practices and literature studies.
Responses from A3 AG till now: 23 commitments and 33 interventions described (annex 6).
Communication issues (EC)
Petra Leroy Cadova and Isabelle Deve, European Commission (PLC and ID) presented the past achievements and future plans for the communication of the EIP for AHA (annex 6). In the last year several leaflets and booklets were made, as well as some videos. A twitter account was also opened.
In the 2014 Conference of Partners, the first results of the Partnership will be showcased. The goal is to raise awareness to the new Commissioners. EC will welcome ideas and information about how the AG would like their work to be given visibility.
Conclusions of the day and future actions (EC)
· The ambition for 2014 is high and this requires a lot from everyone; if frailty is to become an important issue on the agenda, we need concentrate on the items on the roadmap and on monitoring the feedback on results obtained and the activities being undertaken by the partners.
· The EIP will have to demonstrate tangible results taking stock of what has been achieved. Politically, it is important to show to the new College of Commissioners the achievements from this new partnership model.
· The main focus of A3 AG work in 2014 is summarized in the retro planning and have two main tracks of action: individual commitments (progress in implementing actions) and collaborative work. It is very important to have by September concrete results to showcase during the next Conference of Partners.