Frailty Screening and Management for Older Australians in General Practice: Mixed Methods Evaluation

Area of Science:

• Gerontology
• Primary Care Medicine
• Public Health

Background:

• Frailty is a significant risk factor for adverse health outcomes in aging populations.
• International guidelines advocate for frailty screening in primary care, yet it's not standard practice in Australia.
• Early identification and intervention can halt or reverse frailty progression.

Purpose of the Study:

• To investigate the prevalence of frailty among Australians aged 75 and older.
• To assess the resources needed for frailty management.
• To identify determinants for implementing frailty screening and management within the 75+ Health Assessment (75+HA).

Main Methods:

• A mixed-methods evaluation was conducted in 24 Australian general practices.
• The FRAIL (Fatigue, Resistance, Ambulation, Illnesses, Loss of weight) Scale Tool was integrated into the 75+HA.
• Data collected included FRAIL scores, hospitalizations, interventions, staff perceptions, and qualitative interviews with staff and patients.

Main Results:

• 15% of 1484 screened individuals (≥75 years) were frail, with frail individuals more likely to be female, older, and on more medications.
• Frail patients had higher rates of nonelective hospitalizations compared to prefrail and robust individuals.
• Common management recommendations included medication reviews, aged care support, and exercise; barriers included health, transport, cost, and time.

Conclusions:

• Integrating the FRAIL Scale Tool into the 75+HA offers a funded opportunity for proactive frailty management in primary care.
• The tool is valued for its simplicity and ease of integration; software integration would enhance adoption.
• Further research is needed in diverse settings, including Aboriginal and Torres Strait Islander populations, to improve frailty prevention and management.