Summary
The “electronic Frailty Index (eFI)” is discussed, by NHS England’s National Clinical Director for Older People and Person Centred Integrated Care, as a validated tool which might assist in the proactive identification, diagnosis and management of frailty.
Potentially, the eFI can analyse data already collected and coded routinely within general practices to differentiate between older patients with mild, moderate and severe levels of frailty. The aim is then to target resources more precisely to better avoid the risk of costly adverse outcomes such as avoidable mortality, preventable hospitalisations or premature / unnecessary nursing home admissions.
“ …screening for frailty now creates the opportunity to identify people in our local populations living with severe frailty, thereby opening the way for targeted assessment of need and better coordination and planning for delivery of interventions. This provides us with greater opportunity to reduce the likelihood and impact of significant future life events”.
Reference
Why is diagnosing frailty important? – Professor Martin Vernon. [Online]: NHS England, September 19th 2016.
This relates to:
Reference
Clegg, A. Bates, C. [and] Young, J. [et al] (2016). Development and validation of an electronic frailty index using routine primary care electronic health record data. Age and Ageing. May 2016; 45(3): 353-60.
Related information / guidance for primary care:
Reference
Toolkit for general practice in supporting older people living with frailty. Leeds: NHS England, March 2017.
and:
Reference
Recognising and managing frailty in primary care. Effectiveness Matters. 2nd Edition. York: Centre for Reviews and Dissemination: University of York, Connected Bradford (part of Connected Health Cities) [and] Yorkshire and Humber AHSN Improvement Academy, May 16th 2017.
Possibly of interest:
Reference
Updated guidance on supporting routine frailty identification and frailty care through the GP Contract 2017/2018. Leeds: NHS England, September 29th 2017.
On Count-Based Scores for Measuring and Predicting Multimorbidity
Writing from a contrary position, probably, the authors of the following article appear to cast doubt on the value of count-based measures of multi-morbidity when it comes to predicting emergency admissions, functional decline and other adverse outcomes.
Reference
Wallace, E. McDowell, R. Bennett, K. [et al] (2016). Comparison of count-based multimorbidity measures in predicting emergency admission and functional decline in older community-dwelling adults: a prospective cohort study. BMJ Open. September 20th 2016; 6(9): e013089.
