Use of the electronic Frailty Index to identify vulnerable patients: a pilot study in primary care
Use of the electronic Frailty Index to identify vulnerable patients: a pilot study in primary care
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DOI：
10.3399/bjgp17x693089
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发表时间：
2017-11-01
影响因子：
5.9
通讯作者：
Sayer, Avan A.
中科院分区：
文献类型：
--
作者：
Lansbury, Lynn N.;Roberts, Helen Clare;Sayer, Avan A.
背景识别虚弱是为处于不良健康结果高风险中的老年人提供适当治疗的关键。为初级保健提出的筛查工具往往涉及额外的工作量。电子虚弱指数（eFI）有可能克服这个问题。AimTo评估的可行性和可接受性，使用eFI在初级care.Design和settingPilot研究在一个郊区的初级保健实践在英格兰南部2016.Method使用的eFI在初级保健TPP SystmOne数据库的工作人员在实践中，一个全面的老年评估（CGA）诊所正在试行。实践数据管理员为所有患者（n = 6670）运行eFI报告。使用出生日期识别年龄≥ 75岁的患者（n = 589）。参加CGA诊所的患者（n = 18）。ResultsPractice工作人员在5分钟内运行的eFI报告，他们报告是可行的，可以接受的。年龄≥ 75岁（平均83岁，范围75 - 102岁）的所有患者的eFI范围为0.03 - 0.61（平均0.23）。对于CGA患者（平均82岁，范围75 - 94岁），eFI范围为0.19 - 0.53（平均0.33）。重要的是，eFI分数确定了几乎12%的患者年龄= 75岁，在这种做法有严重的frailty.ConclusionIt是可行的，可以接受的，使用eFI在这个试点研究。CGA患者的平均eFI较高，证明了虚弱识别的结构有效性。实践工作人员认识到，eFI有可能识别出前2%的弱势患者，以避免计划外入院。
BackgroundIdentifying frailty is key to providing appropriate treatment for older people at high risk of adverse health outcomes. Screening tools proposed for primary care often involve additional workload. The electronic Frailty Index (eFI) has the potential to overcome this issue.AimTo assess the feasibility and acceptability of using the eFI in primary care.Design and settingPilot study in one suburban primary care practice in southern England in 2016.Method Use of the 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 = 6670). 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).ResultsPractice staff ran the eFI reports in 5 minutes, which they reported was feasible and acceptable. The eFI range was 0.03 to 0.61 (mean 0.23) for all patients aged >= 75 years (mean 83 years, range 75 to 102 years). For CGA patients (mean 82 years, range 75 to 94 years) the eFI range was 0.19 to 0.53 (mean 0.33). Importantly, the eFI scores identified almost 12% of patients aged = 75 years in this practice to have severe frailty.ConclusionIt was feasible and acceptable to use the eFI in this pilot study. A 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.