What is frailty index

Understanding prognosis in the face of not just disease but also frailty can also help us focus not on disease but on health consequences of illness. Can the person think? Care for herself or himself? Interact with others? These questions need to be considered when end-of-life decisions are being discussed Kulminski AM, Edmonton Frail Scale - template. Assessment of severity of frailty.

Edmonton Frail Scale - app. This page is an extension of Frailty. Back To : Frailty. Frailty Index. Once frail, it is difficult to reverse the downward decline. Therefore, it is essential to recognize older adults at risk for frailty in the clinical setting. Early recognition of older adults at risk for frailty can lead to interventions that may prevent or ameliorate frailty.

This maximizes the use of data collected during nursing assessment and reduces testing fatigue for the patient, family, and nurse. FIFE is a item assessment instrument with scores ranging from A score of 0 indicates no frailty; a score of indicates frailty risk; and a score of 4 or greater indicates frailty.

The reliability of FIFE is low range 0. All items were developed through a triangular process involving standard procedures for assessing and evaluating reliability and validity.

FIFE items are easily extrapolated from holistic research and existing nursing datasets. For clinicians, the FIFE may be used as an assessment instrument with the use of all items to determine frailty and individual items to determine risk for frailty.

For researchers, the FIFE may be used to 1 study multiple determinants of frailty; 2 compare frailty among older adult populations using standardized measures; 3 inform the development of interventional studies designed to prevent or thwart frailty; and 4 function as a quality of life outcome.

The following questions and answers may be useful to general practitioners requiring more information about identifying frailty and the role which the electronic Frailty Index eFI plays in the GP contract. If you need any more information, please email us: england. The avoiding unplanned admissions enhanced service AUA ES has been discontinued and funding associated with it placed into the core contract. This new requirement will affect a smaller proportion of patients across England and has more targeted evidence based interventions.

The electronic frailty index eFI uses the existing information within the electronic primary health care record to identify populations of people aged 65 and over who may be living with varying degrees of frailty. When applied to a local population it provides opportunity to predict who may be at greatest risk of adverse outcomes in primary care as a result of their underlying vulnerability.

These deficits include clinical signs e. It is made up of 36 deficits comprising around 2, Read codes. The score is strongly predictive of adverse outcomes and has been validated in around , patient records. It presents an output as a score indicating the number of deficits that are present out of a possible total of 36, with the higher scores indicating the increasing possibility of a person living with frailty and hence vulnerability to adverse outcomes.

The contract requires general practices to identify populations at risk of frailty by using an appropriate tool. NHS England do not require any particular tool to be used.

The eFI is not a clinical diagnostic tool; it is a population risk stratification tool which identifies groups of people who are likely to be living with varying degrees of frailty but it is not able to do this for specific individuals. Therefore, when the eFI identifies an individual who may be living with severe or moderate frailty, direct clinical assessment and judgment should be applied to confirm a diagnosis. Some GP practices may have batch-coded a Read code diagnosis of frailty based solely on an eFI score, without clinical judgement confirming a diagnosis.

This may result in inappropriately targeted interventions and increased workload for a practice the eFI, for example, has relatively high sensitivity and low specificity so tends to over-identify people living with frailty. In response NHS England has issued a statement confirming the importance of clinical judgement.

In terms of choosing between the 2 options, this depends on the list size and how quickly it is possible to go back through the list and do the clinical validation.