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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.