Frailty in hospital: A survey of UK clinicians

Author(s): Taylor J.; Shah P.; Hanley M.; Fox J.; Ali A.; Hyatt R.

Source: European Geriatric Medicine; Sep 2017; vol. 8

Publication Date: Sep 2017

Publication Type(s): Conference Abstract

Abstract:Introduction: Despite numerous national campaigns, frailty remains under-recognised in UK hospitals. We performed the first ever national survey of hospital clinicians designed to identify barriers to the identification and best practice management of frailty. Methods: Electronic and paper based surveys were distributed to hospital-based clinicians across the UK. As well as statement-based agree/disagree/not sure questions across five domains (personal understanding of frailty, identification of frailty, assessments for frailty, management of frailty and education), this survey also included free text comment space to allow broader qualitative evaluation. Results: 402 clinicians were surveyed across 24 specialties and 26 hospital sites. Consultants made up 54% of responders, specialty trainees 19% and junior doctors 24%. Although the majority were familiar with the term frailty, personal understanding was variable, especially amongst junior doctors. 74% of responders agreed frailty assessments should be undertaken for all older people admitted to hospital, yet only 36% felt this was currently feasible. Only 24% of responders reported they used validated assessment tools to identify frailty. Free text responses highlighted scepticism towards the clinical validity and utility of frailty as a clinical syndrome, the perceived value of so-called "end of the bed" assessments, and issues surrounding service capacity. Conclusions: Results highlight multiple Areas for improvement, and raise some interesting questions about the perceived value of frailty assessments in the acute setting. We recommend a particular focus on better training of staff, the promotion of validated frailty assessment tools, and investment in front line services for older people presenting to hospital.
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Database: EMBASE