Several modifiable factors improve frailty through intervention. There are two main families of interventions used in the clinical practice: pharmacological and non-pharmacological ones. The latter includes physical activity and nutrition. A pharmacological intervention aims at reducing polypharmacy which is highly prevalent in the elderly. Physical activity is an effective tool to treat and prevent functional decline and frailty. However, current research indicates that exercise prescriptions must be tailored to the individuals to provide sufficient stimulus for improving the functional and cognitive capacity, as demonstrated in the EU funded Vivifrail project, -in which several researchers of the present proposal participated- has demonstrated. Malnutrition, which is very prevalent in geriatric populations, is one of the main risk factors for the onset of frailty.

Lack of treatment adherence is a potential problem that can hinder the effectiveness of the proposed interventions. Even if the patient is aware of the long-term expected benefits of a change in lifestyle and habits, a decline in motivation along time can lead to treatment abandonment or inadequate compliance to the prescribed interventions. Several theories have been proposed to analyse the behaviour change process, being the Transtheoretical Model the one that has been most extensively and successfully applied in the health domain. On the other hand, when speaking of motivation, it is necessary to differentiate among motivational state and motivational traits and skills. Motivational traits are defined as stable and trans-situational individual differences in preferences related to approximation and avoidance, in the investment of goal-directed effort. In turn, Motivational Skills are defined as integrated, self-regulatory competencies, which are put into practice during the attempt to achieve a goal.

Appropriate characterization of the individual’s motivational traits, skills and state, should lead to more effective motivational interventions, adapted to the needs and profile of the user. Home care systems for self-management of chronic diseases have been a hot topic for decades now. However, they have not had a significant impact on clinical practice. On the one hand, patient engagement in self-management is a prerequisite for success however, it is difficult for general practitioners to get their patients motivated to comply with their new lifestyle. Effective implementation of home care systems requires a careful consideration of the patient’s motivation, the promotion of empowerment, and the adaptation of the interventions to the current stage in the behaviour change process, as critical countermeasures to fight against abandonment and lack of compliance. Finally, clinicians are also usually worried about liability issues and the burden of their work and concerned with monetization of their services.