Feasibility of frailty screening among patients with advanced heart failure

被引:1
作者
Lehto, Hanna-Riikka [1 ,2 ]
Jain, Nelia [1 ,2 ]
Bernacki, Rachelle E. [1 ,2 ]
Landzberg, Michael J. [2 ,3 ]
Desai, Akshay S. [2 ,4 ]
Orkaby, Ariela R. [2 ,5 ]
机构
[1] Dana Farber Canc Inst, Dept Psychosocial Oncol & Palliat Care, Boston, MA 02115 USA
[2] Harvard Med Sch, Boston, MA 02115 USA
[3] Boston Childrens Hosp, Dept Cardiol, Boston, MA USA
[4] Brigham & Womens Hosp, Div Cardiovasc Med, Boston, MA USA
[5] Vet Affairs Boston Healthcare Syst, New England GRECC, Boston, MA USA
关键词
quality improvement; healthcare quality improvement; continuous quality improvement; ELDERLY-PATIENTS; PALLIATIVE CARE; OLDER-ADULTS; PREVALENCE; MORTALITY; INDEXES; DISABILITY; PREDICTION; FRACTURES; OUTCOMES;
D O I
10.1136/bmjoq-2023-002430
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background Frailty is common among patients with advanced heart failure (HF), and screening for frailty to guide care is recommended. Although multiple tools are available to screen for frailty, the feasibility of routinely incorporating frailty screening into daily clinical practice among hospitalised advanced HF patients has not been rigorously tested.Methods This was a prospective, single-centre, quality improvement study. Two brief frailty screening tools were incorporated into palliative care consultations for all patients >= 50 years from August 2021 to October 2022. In the first phase, the Clinical Frailty Scale (CFS) was implemented, followed by the Study of Osteoporotic Fracture (SOF) tool or a modified SOF (mSOF) version in the second phase. The primary outcome was feasibility (%) of performing frailty screenings for this high-risk population.Results A total of 212 patients (mean age 69 +/- 10 years, 69% male, 79% white, 30% with ischaemic HF) were referred for palliative care consultation during the study period. Overall, frailty screens were completed in 86% (n=183) of patients. CFS and mSOF reached >80% of adoption, while SOF adoption was 54%. Altogether, 52% of the population screened frail by use of CFS and 52% also by mSOF. All clinicians (n=6) participating in the study reported that frailty screening tools were useful and acceptable, and 83% reported plans for continued utilisation in future clinical practice.Conclusions Frailty screening with CFS or mSOF tools was feasible in hospitalised patients with advanced HF. Tools that require physical assessment were more challenging to implement. These data support the feasibility of incorporating questionnaire-based frailty screening in a busy hospital setting.
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共 48 条
[1]   Advancing a Conceptual Model of Evidence-Based Practice Implementation in Public Service Sectors [J].
Aarons, Gregory A. ;
Hurlburt, Michael ;
Horwitz, Sarah McCue .
ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH, 2011, 38 (01) :4-23
[2]   Gait Speed as an Incremental Predictor of Mortality and Major Morbidity in Elderly Patients Undergoing Cardiac Surgery [J].
Afilalo, Jonathan ;
Eisenberg, Mark J. ;
Morin, Jean-Francois ;
Bergman, Howard ;
Monette, Johanne ;
Noiseux, Nicolas ;
Perrault, Louis P. ;
Alexander, Karen P. ;
Langlois, Yves ;
Dendukuri, Nandini ;
Chamoun, Patrick ;
Kasparian, Georges ;
Robichaud, Sophie ;
Gharacholou, S. Michael ;
Boivin, Jean-Francois .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2010, 56 (20) :1668-1676
[3]   Feasibility and Rationale for Incorporating Frailty and Cognitive Screening Protocols in a Preoperative Anesthesia Clinic [J].
Amini, Shawna ;
Crowley, Samuel ;
Hizel, Loren ;
Arias, Franchesca ;
Libon, David J. ;
Tighe, Patrick ;
Giordano, Chris ;
Garvan, Cynthia W. ;
Enneking, F. Kayser ;
Price, Catherine C. .
ANESTHESIA AND ANALGESIA, 2019, 129 (03) :830-838
[4]   Regulation of Circulating Progenitor Cells in Left Ventricular Dysfunction [J].
Boilson, Barry A. ;
Larsen, Katarina ;
Harbuzariu, Adriana ;
Delacroix, Sinny ;
Korinek, Josef ;
Froehlich, Harald ;
Bailey, Kent R. ;
Scott, Christopher G. ;
Shapiro, Brian P. ;
Boerrigter, Guido ;
Chen, Horng H. ;
Redfield, Margaret M. ;
Burnett, John C., Jr. ;
Simari, Robert D. .
CIRCULATION-HEART FAILURE, 2010, 3 (05) :635-+
[5]   How We Design Feasibility Studies [J].
Bowen, Deborah J. ;
Kreuter, Matthew ;
Spring, Bonnie ;
Cofta-Woerpel, Ludmila ;
Linnan, Laura ;
Weiner, Diane ;
Bakken, Suzanne ;
Kaplan, Cecilia Patrick ;
Squiers, Linda ;
Fabrizio, Cecilia ;
Fernandez, Maria .
AMERICAN JOURNAL OF PREVENTIVE MEDICINE, 2009, 36 (05) :452-457
[6]   Frailty assessment instruments: Systematic characterization of the uses and contexts of highly-cited instruments [J].
Buta, Brian J. ;
Walston, Jeremy D. ;
Godino, Job G. ;
Park, Minsun ;
Kalyani, Rita R. ;
Xue, Qian-Li ;
Bandeen-Roche, Karen ;
Varadhan, Ravi .
AGEING RESEARCH REVIEWS, 2016, 26 :53-61
[7]   Frailty and Risk of Adverse Outcomes in Hospitalized Older Adults: A Comparison of Different Frailty Measures [J].
Chong, Edward ;
Ho, Esther ;
Baldevarona-Llego, Jewel ;
Chan, Mark ;
Wu, Lynn ;
Tay, Laura .
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, 2017, 18 (07) :638.e7-638.e11
[8]   Frailty in elderly people [J].
Clegg, Andrew ;
Young, John ;
Iliffe, Steve ;
Rikkert, Marcel Olde ;
Rockwood, Kenneth .
LANCET, 2013, 381 (9868) :752-762
[9]   Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women [J].
Ensrud, Kristine E. ;
Ewing, Susan K. ;
Taylor, Brent C. ;
Fink, Howard A. ;
Cawthon, Peggy M. ;
Stone, Katie L. ;
Hillier, Teresa A. ;
Cauley, Jane A. ;
Hochberg, Marc C. ;
Rodondi, Nicolas ;
Tracy, J. Kathleen ;
Cummings, Steven R. .
ARCHIVES OF INTERNAL MEDICINE, 2008, 168 (04) :382-389
[10]   A Comparison of Frailty Indexes for the Prediction of Falls, Disability, Fractures, and Mortality in Older Men [J].
Ensrud, Kristine E. ;
Ewing, Susan K. ;
Cawthon, Peggy M. ;
Fink, Howard A. ;
Taylor, Brent C. ;
Cauley, Jane A. ;
Dam, Thuy-Tien ;
Marshall, Lynn M. ;
Orwoll, Eric S. ;
Cummings, Steven R. .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2009, 57 (03) :492-498