Feasibility of implementing a telephone-based frailty assessment.
Feasibility of implementing a telephone-based frailty assessment.
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DOI：
10.1111/jgs.18031
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发表时间：
2022-12
影响因子：
6.3
通讯作者：
Kim, Dae Hyun
中科院分区：
文献类型：
--
作者：
Sison, Stephanie Denise M.;Newmeyer, Natalie;Arias, Karla Tejada;Schoenburg, Racheli;Valencia, Carolina Fonseca;Cheslock, Megan;Raman, Vaishnavi;Driver, Jane A.;Kim, Dae Hyun
尽管关于识别和管理脆弱的重要性的文献越来越多，但其评估在临床环境中一直受到限制。这个质量改进项目的目标是将脆弱性评估整合到常规临床实践中，旨在确定实施电话脆弱性评估的可行性、可接受性和实用性。在2020年9月至2021年6月期间，我们在一家学术初级保健-老年诊所确定了169名确诊的严重疾病患者。通过电话联系患者，并使用有效的筛查工具评估他们目前的医疗、功能、营养、认知和情绪状况。然后使用基于电子病历(EMR)的脆弱性指数计算器计算赤字累积脆弱性得分，并为提供者生成带有建议的标准化文档。主要结果是可行性，以成功评估的患者比例来衡量。次要结果包括每个领域的完成率、管理时间、提供者的感知和评估的临床效用。共有139名患者(82.2%)获得成功评估，平均年龄82岁，63.3%虚弱。在139项评估中，所有人都完成了医学领域和功能领域的评估，而营养、情绪和认知领域的完成比例分别为88.5%(n=123)、68.3%(n=95)和59.7%(n=83)。进行全面评估平均(标准差)时间为26.1(7.3)分钟。不包括认知和情绪领域，评估平均需要15.7分钟(7.5分钟)。患者的提供者发现评估中的信息有助于评估和管理他们的患者。分别有51.8%和65.0%有活动和智力问题的患者的护理计划在评估后30天内解决了这些问题。实施基于电话的脆弱性评估是可行的、可接受的，并有可能影响老年人的护理计划。这项工作展示了如何将脆弱性评估整合到门诊环境中。
Despite the growing literature on the importance of identifying and managing frailty, its assessment has been limited in clinical settings. With the goal of integrating frailty assessment into routine clinical practice, this quality improvement project aimed to determine the feasibility, acceptability, and utility of administering a telephone-based frailty assessment. Between 9/2020 and 6/2021, we identified 169 established patients with serious illness in an academic primary care-geriatric clinic. Patients were contacted via telephone, and their current medical, functional, nutritional, cognitive and mood status were assessed using validated screening tools. A deficit-accumulation frailty score was then calculated using an electronic medical record (EMR)-based frailty index calculator and standardized documentation with recommendations was generated for providers. The primary outcome was feasibility, measured as the proportion of patients successfully assessed. Secondary outcomes included completion rates of each domain, administration time, providers’ perception, and clinical utility of the assessment. A total of 139 (82.2%) patients, mean age of 82 years, 63.3% frail were successfully assessed. Of the 139 assessments, medical and functional domains were completed for all, while nutrition, mood and cognition were completed 88.5% (n=123), 68.3% (n=95), and 59.7% (n=83) of the time, respectively. Conducting the full assessment took an average (standard deviation) time of 26.1 (7.3) minutes. Without the cognitive and mood domain, assessment took an average of 15.7 (7.5) minutes. Patients’ providers found the information from the assessment helpful in evaluating and managing their patients. Care plans of 51.8% and 65.0% of patients who had mobility and mind issues, respectively, addressed these domains within 30 days after the assessment. Implementation of the telephone-based frailty assessment is feasible, acceptable, and has the potential to influence the care plans of older adults. This work demonstrated how frailty assessment can be integrated in the outpatient setting.
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影响因子：
39.2
作者：
Kim DH;Pawar A;Gagne JJ;Bessette LG;Lee H;Glynn RJ;Schneeweiss S
通讯作者：
Schneeweiss S
基于Web的软件应用程序用于老年人的脆弱评估：对当前状态的范围审查，对未来发展的见解。
影响因子：
4.1
作者：
Chang R;Low H;McDonald A;Park G;Song X
通讯作者：
Song X
影响因子：
39
作者：
Kim, Dae Hyun;Afilalo, Jonathan;Lipsitz, Lewis A.
通讯作者：
Lipsitz, Lewis A.
影响因子：
6.3
作者：
Cooper, Lisa;Loewenthal, Julia;Frain, Laura N.;Tulebaev, Samir;Cardin, Kristin;Hshieh, Tammy T.;Dumontier, Clark;Streiter, Shoshana;Joseph, Carly;Hilt, Austin;Theou, Olga;Rockwood, Kenneth;Orkaby, Ariela R.;Javedan, Houman
通讯作者：
Javedan, Houman
DOI：
10.1016/j.jamda.2014.07.006
发表时间：
2015-01-01
影响因子：
7.6
作者：
Fairhall, Nicola;Sherrington, Catherine;Cameron, Ian D.
通讯作者：
Cameron, Ian D.