Characterising the primary care population with frailty to better stratify and target healthcare interventions

Advances in healthcare have increased the lifespans of many millions of people, but as an unfortunate consequence increasing numbers of people are living with long-term conditions and frailty. Health services, and particularly GPs, face a major challenge in how best to provide high quality and appropriate care to growing numbers of frail older adults, and also how to reduce the risk of further frailty leading to increased dependence on carers and on health and social care. Health services tend to be “reactive” and to adapt care only after a patient is already frail, which can lead to an unnecessary increase in ill-health and emergency hospitalizations.  Knowledge about a patient’s level and history of frailty, could instead help services be pro-active in identifying patients where preventative actions would be most beneficial and in selecting individually tailored interventions that can have maximum benefit. 

Until now there was no easy method for identifying frail patients in primary care. Recently however, a “frailty index” was developed that can be quickly computed using a patient’s electronic health record. We will use this measure in conjunction with the CPRD, a national dataset of patient records from more than 650 GP practices, to gain a better understanding of the extent and nature of frailty in the UK, including degrees of frailty and how these vary by age, sex, socio-economic group, medical conditions and region; how frailty progresses in individuals over time; whether there are distinct sub-types of frailty, such and physical and mental; and relationships between frailty and health outcomes including hospitalisation and death. The knowledge and understanding gained from this will then be used to inform the design of clinical trials that use information about a patient’s frailty to better plan services and treatments for that patient.

Amount awarded: £124,161