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. 2017 Nov;67(664):e751-e756.
doi: 10.3399/bjgp17X693089. Epub 2017 Sep 25.

Use of the electronic Frailty Index to identify vulnerable patients: a pilot study in primary care

Lynn N Lansbury  1 , Helen Clare Roberts  2 , Esther Clift  3 , Annie Herklots  4 , Nicola Robinson  4 , Avan A Sayer  5
Affiliations

Use of the electronic Frailty Index to identify vulnerable patients: a pilot study in primary care

Lynn N Lansbury et al. Br J Gen Pract. 2017 Nov.

Abstract

Background: Identifying 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.

Aim: To assess the feasibility and acceptability of using the eFI in primary care.

Design and setting: Pilot 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).

Results: Practice 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.

Conclusion: It 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.

Keywords: eFI; electronic Frailty Index; frail older adults; frailty; general practice; older people; primary health care.

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Figures

Figure 1.
Figure 1.
Prevalence of electronic Frailty Index (eFI) categories for all patients aged ≥75 years.
Figure 2.
Figure 2.
Prevalence of electronic Frailty Index (eFI) categories for 18 patients aged ≥75 years referred to the comprehensive geriatric assessment (CGA) clinic.
Figure 3.
Figure 3.
Frequencies of electronic Frailty Index (eFI) for all patients aged ≥75 years.
See this image and copyright information in PMC

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