Use of the electronic Frailty Index in primary healthcare: a pilot study

Abstract

Background Identifying frailty is key to providing appropriate treatment for older people at high risk of adverse health outcomes. Screening tools proposed for primary healthcare often involve additional workload. The electronic Frailty Index (eFI) has the potential to overcome this issue.

Aim To assess the feasibility and acceptability of using eFI in primary healthcare.
Design and Setting Pilot study in one primary healthcare practice in England in 2016.

Methods Use of the electronic Frailty Index (eFI) on the primary care TPP SystmOne database was explained to staff at the practice where a Comprehensive Geriatric Assessment (CGA) Clinic was being trialled. The practice data manager ran an eFI report for all patients (N=6,670). Date of birth was used to identify patients aged ≥75 years (n=589). The eFI was determined for patients attending the CGA Clinic (n=18).

Results Practice staff ran the eFI reports in 5 minutes, which they reported was feasible and acceptable. The eFI range was 0.03 – 0.61 (mean 0.23) for all patients aged ≥75 years (mean 83 years; range 75 – 102 years). For CGA patients (mean 82 years; range75 – 91 years) the eFI range was 0.19 – 0.53 (mean 0.33).

Conclusions It was feasible and acceptable to use the eFI in this pilot study. The higher mean eFI in the CGA patients demonstrated construct validity for frailty identification. Practice staff recognised the potential for the eFI to identify the top 2% of vulnerable patients for Avoiding Unplanned Admissions.

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Identifiers

ORCID for Helen Roberts: orcid.org/0000-0002-5291-1880

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