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GPs can risk-stratify frail patients in ‘only a few minutes’ using tool

GPs can risk stratify patients at risk of frailty in just a few minutes using the electronic frailty index, according to a new pilot study.

The study found that using the electronic frailty index (eFI) was acceptable to practice staff and simple and quick to run, adding support to its use in primary care.

It was announced earlier this year under the new contract that GPs would be obliged to create risk registers for frail patients aged over 65, an alternative to the previously proposed avoiding unplanned admissions DES, or face breach of contract notices.

The study, led by researchers at the University of Southampton, assessed the acceptability of running an eFI report for just under 600 patients aged 75 or over in one UK practice, as well as looking at how long it took to run. They found that it took just five minutes to obtain an eFI score for all of the patients, which was acceptable to the practice manager and the practice data manager.

GPs and specialist elderly care nurses had been advised to refer patients they felt were suitable for a comprehensive geriatrician assessment and the study found those who were referred had higher average eFI scores than the general older patient population, adding validity to the use of the tool to risk-stratify patients. The study also found that approximately 12% of patients aged 75 or over in the practice had severe frailty. 

The authors said in the paper: ‘This pilot study adds to existing evidence that the eFI is quick and simple to use, and could be important in primary care to stratify practice populations by frailty.

‘Additionally, researchers in primary health care may find eFI a practical and effective method to screen populations to identify potential study participants living with frailty. The experience of using the eFI in this study would support the need for further evaluation in clinical practice.’

The findings come as NHS England warned in September that GPs should not be using the eFI to batch diagnose patients as frail if the eFI report showed them to be at risk. 

BGJP 2017; available online 26th September


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