TY - JOUR
T1 - Practitioner perceptions of the feasibility of common frailty screening instruments within general practice settings
T2 - a mixed methods study
AU - Ambagtsheer, Rachel C.
AU - Casey, Mavourneen G.
AU - Lawless, Michael
AU - Archibald, Mandy M.
AU - Yu, Solomon
AU - Kitson, Alison
AU - Beilby, Justin J.
PY - 2022/6/27
Y1 - 2022/6/27
N2 - Background: Frailty is a highly prevalent clinical syndrome increasing older people’s vulnerability to risk of adverse outcomes. Better frailty identification through expanded screening implementation has been advocated within general practice settings, both internationally and within Australia. However, little is known about practitioner perceptions of the feasibility of specific instruments, and the underlying motivations behind those perceptions. Consequently, the purpose of this study was to explore the attitudes and perceptions of a convenience and volunteer sample of Australian general practitioners (GPs) and practice nurses (PNs) towards common frailty screening instruments. Methods: The feasibility of several frailty screening instruments (PRISMA-7 [P7], Edmonton Frail Scale [EFS], FRAIL Questionnaire [FQ], Gait Speed Test [GST], Groningen Frailty Indicator [GFI], Kihon Checklist [KC] and Timed Up and Go [TUG]) to 43 Australian GPs and PNs was assessed. The study adopted a concurrent embedded mixed-methods design incorporating quantitative (ranking exercise) and qualitative (content analysis) data collection integrated during the analysis phase. Results: Practitioners assessed multi-dimensional instruments (EFS, GFI, KC) as having relatively higher clinical utility, better integration into existing assessment processes and stronger links to intervention over uni-dimensional (GST, TUG) and simple (FQ, P7) instruments. Conclusions: While existing frailty screening instruments show promise as an initial step in supporting better care for older people, all the included instruments were associated with perceived advantages and disadvantages. Ultimately, clinicians will need to weigh several factors in their selection of the optimal screening instrument. Further translational research, with a focus on contextual fit, is needed to support clinical decision-making on the selection of instruments for frailty screening.
AB - Background: Frailty is a highly prevalent clinical syndrome increasing older people’s vulnerability to risk of adverse outcomes. Better frailty identification through expanded screening implementation has been advocated within general practice settings, both internationally and within Australia. However, little is known about practitioner perceptions of the feasibility of specific instruments, and the underlying motivations behind those perceptions. Consequently, the purpose of this study was to explore the attitudes and perceptions of a convenience and volunteer sample of Australian general practitioners (GPs) and practice nurses (PNs) towards common frailty screening instruments. Methods: The feasibility of several frailty screening instruments (PRISMA-7 [P7], Edmonton Frail Scale [EFS], FRAIL Questionnaire [FQ], Gait Speed Test [GST], Groningen Frailty Indicator [GFI], Kihon Checklist [KC] and Timed Up and Go [TUG]) to 43 Australian GPs and PNs was assessed. The study adopted a concurrent embedded mixed-methods design incorporating quantitative (ranking exercise) and qualitative (content analysis) data collection integrated during the analysis phase. Results: Practitioners assessed multi-dimensional instruments (EFS, GFI, KC) as having relatively higher clinical utility, better integration into existing assessment processes and stronger links to intervention over uni-dimensional (GST, TUG) and simple (FQ, P7) instruments. Conclusions: While existing frailty screening instruments show promise as an initial step in supporting better care for older people, all the included instruments were associated with perceived advantages and disadvantages. Ultimately, clinicians will need to weigh several factors in their selection of the optimal screening instrument. Further translational research, with a focus on contextual fit, is needed to support clinical decision-making on the selection of instruments for frailty screening.
KW - 80 and over
KW - Aged
KW - Community health nursing
KW - Frailty
KW - General practice
KW - Mass screening
KW - Primary care
UR - http://www.scopus.com/inward/record.url?scp=85132975607&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/1102208
U2 - 10.1186/s12875-022-01778-9
DO - 10.1186/s12875-022-01778-9
M3 - Article
C2 - 35754037
AN - SCOPUS:85132975607
SN - 2731-4553
VL - 23
JO - BMC Primary Care
JF - BMC Primary Care
M1 - 160
ER -