RT Journal Article
SR Electronic
T1 Frailty assessment in primary health care and its association with unplanned secondary care use: a rapid review
JF BJGP Open
JO Br J Gen Pract Open
FD Royal College of General Practitioners
SP bjgpopen18X101325
DO 10.3399/bjgpopen18X101325
A1 Ben R Davies
A1 Helen Baxter
A1 James Rooney
A1 Phillip Simons
A1 Ann Sephton
A1 Sarah Purdy
A1 Alyson L Huntley
YR 2018
UL http://bjgpopen.org/content/early/2018/01/10/bjgpopen18X101325.abstract
AB Background The growing frail, older population is increasing pressure on hospital services. This is directing the attention of clinical commissioning groups towards more comprehensive approaches to managing frailty in the primary healthcare environment.Aim To review the literature on whether assessment of frailty in primary health care leads to a reduction in unplanned secondary care use.Design & setting A rapid review involving a systematic search of Medline and Medline In-Process.Method Relevant data were extracted following the iterative screening of titles, abstracts, and full texts to identify studies in the primary or community healthcare setting which assessed the effect of frailty on unplanned secondary care use between January 2005–June 2016.Results The review included 11 primary studies: nine observational studies; one randomised controlled trial (RCT); and one non-randomised controlled trial (nRCT). Eight out of nine observational studies reported a positive association between frailty and secondary care utilisation. The RCT and nRCT reported conflicting findings.Conclusion Older people identified as frail in a primary healthcare setting were more likely to be admitted to hospital. Based on the limited and equivocal trial evidence, it is not possible to draw firm conclusions regarding appropriate tools for the identification and management of frail older people at risk of hospital admission.