Frailty Assessment Research – Potential Data Sources

November 18, 2014 | Dr Lotte

For my Frailty Assessment research, I am planning to incorporate the development of a tool that enables frailty assessment in different care settings with the aim of supporting communication and information sharing between healthcare professionals, patients, and different healthcare settings.

I am particularly interested in comparing primary care data to secondary care data and keen to investigate if I’m able to use the same score in both settings, using the data collected to determine whether trends exist to predict frailty. Ultimately avoiding admission to hospital. I am in the process of negotiating with primary care trusts to gain access to some of their data, anonymised of course, so that we might be able to see what triggers patients in the community to tip them from their baseline and deteriorate so much that they end up in hospital. To be able to understand that tipping point will be crucial for predicting frailty, although it might prove to very challenging to get to this point. To ensure I can get a clear picture, research has shown that I would need patients that are over 65 (due to NICE guidelines setting the limit as above 65 for elderly) and that I would need to study them for 12 months.

I will compare traditional clinical (physical health-based) scores to a patient-centred score (incorporating mental, social, environmental factors as well as physical) to compare predictive power. I am also going to do some qualitative analysis looking into how healthcare professionals and patient/ carers view the use of frailty models/ tools, and how they will impact on clinical management and outcomes, data availability and planned analysis. Understanding staff, patients and carers perceptions of what elements in the score are needed, particularly around the language used for frailty, would be investigated in focus groups (quantitative analysis).

To be able to draw any conclusions regarding the impact of the intervention it will be necessary to understand the extent to which the intervention is implemented and how effectively it is being utilised.

My overall aim is to develop and validate a frailty diagnosis tool to be practically implemented by a range of health care professionals but if the tool could be used by patients themselves, then that would be an absolute bonus.


 

lotte

Lotte is a consultant in General Internal Medicine, and currently is a Clinical Research Fellow in e-health and telemedicine in chronic diseases for CLAHRC NIHR North West London with Imperial College London.

Lotte graduated from University of Copenhagen in 2001, and has completed a 6 year SpR rotation in North West London in 2013. She has undergone a comprehensive training in gastroenterology and general internal medicine. She has furthered her experience with 2 fellowships one at The Royal Prince Alfred Hospital in Sydney, Australia (Oct 2010- Oct 2011) and one at John Radcliffe Hospital in Oxford (Aug 2006- Sept 2007).

Having worked first and foremost in Gastroenterology but also in General Internal Medicine and Acute Medicine, she has not only acquired a wealth of clinical knowledge, but also gained the ability to apply this knowledge to make effective clinical decisions. This has enabled her to contribute to individual patient care and to address both the chronic and psychosocial aspects of patient care. This was demonstrated when she developed and lead a patient day care centre where she taught medical staff (nurses, junior doctors and GPs) and patients additionally, Lotte created a computer based teaching aid and remote learning initiate in the form of an Inflammatory Bowel Disease (IBD) website for patients and GPs, to teach and empower them in dealing with IBD. Her academic research involves having authored 17 original articles published in national and international peer reviewed journals as well as authored three book chapters. She has presented her research in many national and international meetings.

During her training Lotte has been involved in many major research projects in Gastroenterology and General Internal Medicine (GIM) with the aim of assessing current standards of practise that will lead to improvements in quality of care. Lotte has also been actively involved in many national and international studies and has been a collaborator in many multicenter clinical trials (phase I, II, and III). In addition, she has participated actively in the International IOIBD multiplex family study, as pioneered the DCCD (Danish Crohn and colitis database).

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