The Implementation of Frailty Assessment Tools in the Acute Care Setting: A Scoping Review

Area of Science:

• Gerontology
• Geriatric Medicine
• Health Services Research

Background:

• Frailty is a significant predictor of adverse health outcomes in older adults.
• Measuring frailty in acute care settings is challenging due to a lack of standardized tools and implementation difficulties.
• Existing frailty assessment methods vary widely, causing confusion for clinicians.

Purpose of the Study:

• To conduct a scoping review of how frailty is measured and utilized within the acute care setting.
• To map and synthesize the current landscape of frailty assessment tools and their application in hospitals.

Main Methods:

• Utilized Arksey and O'Malley's methodological framework for scoping reviews.
• Conducted a comprehensive search across multiple databases (MEDLINE, EMBASE, CINAHL, SCOPUS, Google Scholar).
• Included primary studies assessing frailty in acute care settings published up to May 2023.

Main Results:

• Identified 2554 relevant studies from an initial search of 8834 articles, with a significant increase in publications over the last five years.
• The most frequently used frailty assessment tools were the Frailty Index (41.0%), Clinical Frailty Scale (23.3%), and Fried Frailty Phenotype (9.3%).
• Overwhelmingly, studies (99.6%) focused on the association between frailty and adverse outcomes or tool validation, with minimal research (0.4%) on prospective care adaptation.

Conclusions:

• While evidence strongly links frailty in acute care to adverse outcomes, there is a notable gap in research regarding the impact of frailty assessment on proactively modifying patient care.
• Further research is essential to explore and establish prospective management strategies for frailty within acute care environments.