Clinical frailty scale as a point of care prognostic indicator of mortality in COVID-19

Clinical frailty scale as a point of care prognostic indicator of mortality in COVID-19: a systematic review and meta-analysis
EClinicalMedicine 21 May 2021 v36(100896)

• Analysis of data from 34 studies (n=18042) suggest a differential stratification of Clinical Frailty Score (CFS) scores in the context of COVID-19 infection, in which CFS 1–3 patients may be considered at lower risk, CFS 4–5 at moderate risk, and CFS 6–9 at high risk of mortality regardless of age.

Ageing: Science, Technology and Healthy Living

Ageing: Science, Technology and Healthy Living
House of Lords Science and Technology Committee 15 January 2021

• This report finds that while life expectancy in the UK has continued to increase year on year, healthy life expectancy – the time an individual can expect to live in good health – has not kept pace. It identifies approaches from science and technology that could help to increase healthy life expectancy, and assesses the role of public health interventions and national regulations in helping people to age more healthily.  
• Includes a range of data tables.

COVID-19 and disruptions to the health and social care of older people in England

COVID-19 and disruptions to the health and social care of older people in England
Institute for Fiscal Studies 6 November 2020

• The COVID-19 pandemic has led to dramatic changes in the delivery of routine health care in England. To prioritise access to hospital beds, staff and ventilators for COVID-19 patients, and to minimise the risk of infection for other patients, much routine health care was postponed or replaced with online or phone consultations. In addition, many would-be patients declined to seek care in the first place. In this briefing note, we use novel data to quantify these disruptions to care among older people in England in the early stages of the pandemic, and to examine who was most affected.

Virtual geriatric clinics and the COVID-19 catalyst: a rapid review

Virtual geriatric clinics and the COVID-19 catalyst: a rapid review
Age and Ageing, v49(6) November 2020, Pages 907–914, https://doi.org/10.1093/ageing/afaa191

• A rapid review to describe the satisfaction, clinic productivity, clinical benefit, and costs associated with the virtual geriatric clinic model of care. Analysis of 9 studies (n=975 patients) indicates that virtual geriatric clinics demonstrate evidence of productivity, benefit to patients, cost effectiveness and patient satisfaction with the treatment provided.

Reducing Health Inequalities for People Living with Frailty in vulnerable populations

Reducing Health Inequalities for People Living with Frailty A resource for commissioners, service providers and health, care and support staff
Friends, Families and Travellers 6 October 2020

• This resource shares practical recommendations and examples of how commissioners, service providers and health, care and support staff can successfully overcome barriers to healthcare for people at greater risk of frailty, including people experiencing deprivation, people who are homeless, people experiencing substance misuse, people with learning disabilities, LGB&T people, people with mental health needs, people from Gypsy and Traveller communities, and vulnerable migrants.

Beneficial innovations from COVID-19

Beneficial innovations from COVID-19
British Geriatrics Society 3 July 2020

• Examples of innovations contributed by BGS members that have been implemented in their areas:
• Proactive anticipatory care for older people with frailty
• Urgent primary care response
• Specialist-les assessment and treatment at home
• Coordinated multi-agency support for care homes
• Person-centred advance care planning
• Age-attuned acute care
• Safe, effective and timely transfers of care
• Optimising recovery and rehabilitation
• Virtual clinics
• Digitally-enabled care

Towards an understanding of the burdens of medication management affecting older people: the MEMORABLE realist synthesis.

Towards an understanding of the burdens of medication management affecting older people: the MEMORABLE realist synthesis.
BMC Geriatr 20, 183 (5 June 2020). https://doi.org/10.1186/s12877-020-01568-x

• MEMORABLE (MEdication Management in Older people: Realist Approaches Based on Literature and Evaluation) is a realist synthesis which aimed to understand how, why and for whom complex medication management works in older people.

Abstract

In Focus: Experiences of older age in England

In Focus: Experiences of older age in England
Independent Age 15 April 2020

• Evidence also shows that many people aged 65 and over are facing significant challenges and major inequalities exist. This project explores the reality of life for older people whose voices can be less often heard in debates about ageing and what is important for people in this age group. It has focused on the experiences of specific groups of older people: people with mental or physical health conditions; people providing informal care; Black, Asian and Minority Ethnic (BAME) groups; people on low incomes; and people without children.

Successful care transitions for older people: a systematic review and meta-analysis of the effects of interventions that support medication continuity

Successful care transitions for older people: a systematic review and meta-analysis of the effects of interventions that support medication continuity
Age and Ageing, afaa002, 20 February 2020, https://doi.org/10.1093/ageing/afaa002

• This review evaluates interventions that support successful transitions of care for older patients when discharged from hospital through enhanced medication continuity. Analysis of 24 studies (participants = 17,664) the review found that interventions that bridged the transition for up to 90 days were more likely to support successful transitions while those that included self-management, telephone follow-up and medication reconciliation activities were also likely to be effective.

New Horizons in the use of routine data for ageing research

New Horizons in the use of routine data for ageing research
Age and Ageing, Volume 49, Issue 5, September 2020, Pages 716–722, https://doi.org/10.1093/ageing/afaa018

• This article describes the challenges in using routine data at the level of coding, data analysis and in the application of findings to everyday care for older people.

 Abstract

Frailty: implications for clinical practice and public health

Frailty: implications for clinical practice and public health
The Lancet v394(10206), P1365-1375, 12 October 2019 [NHS OpenAthens 90 day embargo]

• An overview of the global impact and burden of frailty, the usefulness of the frailty concept in clinical practice, potential targets for frailty prevention, and directions that need to be explored in the future.

Modeling the Economic Impact of Interventions for Older Populations with Multimorbidity

Modeling the Economic Impact of Interventions for Older Populations with Multimorbidity: A Method of Linking Multiple Single-Disease Models.
Med Decis Making. 2019;39(7):842-856. doi:10.1177/0272989X19868987

• A proof-of-concept method of modeling multiple conditions in a single decision-analytic model to estimate the impact of multimorbidity on the cost-effectiveness of interventions.

Abstract

The contribution of implementation science to improving the design and evaluation of integrated care programmes for older people with frailty

The contribution of implementation science to improving the design and evaluation of integrated care programmes for older people with frailty
Journal of Integrated Care 2019, v27(3) p232-240 https://doi.org/10.1108/JICA-07-2018-0048

• The aim of this paper is to discuss three potential contributions of implementation science which are central to the field that could help clinicians and researchers better design and evaluate more effective integrated care programmes for older people with frailty. These are: stakeholder engagement; using implementation science frameworks; and assessment of implementation strategies and outcomes.

Predicting poorer health outcomes in older community-dwelling patients with multimorbidity:

Predicting poorer health outcomes in older community-dwelling patients with multimorbidity: prospective cohort study assessing the accuracy of different multimorbidity definitions
BMJ Open. 2019; 9(1): e023919. 4 January 2019

• This study compared the accuracy of medication classes count and diagnosis-based multimorbidity measures at higher cut-points to identify older community-dwelling patients who are at risk of poorer health outcomes based on data from 15 GP practices in Ireland. 
• Neither measure demonstrated high sensitivity. However, medication classes count using a definition of 10 or more regular medication classes to define multimorbidity had higher specificity for predicting poorer health outcomes. While having limitations, this definition could be used for proactive identification of patients who may benefit from targeted clinical care.