Aims
Early, preventative care within general practices is vital to proactively identify and treat frailty. This project aimed to increase uptake of frailty identification of older adults in general practices in Adelaide.
Methods
Mixed-methods implementation study. The intervention was a three-month quality improvement sprint involving practice champions, audits and action plans, use of a frailty toolkit, coaching huddles, education and training workshops, and facilitated support from primary care frailty experts. Sprint activities with 16 general practices facilitated frailty identification using FRAIL scale and sarcopenia assessments with patients aged 65 years and above. Practice outcomes and patient quality of life (QOL) outcomes were assessed pre-and post-sprint. Experiences of the program were gained through interviews. Quantitative data were analysed descriptively. Qualitative data were analysed using content analysis.
Results
From the 16 general practices, 1090 patients were screened with 582 newly diagnosed with frailty. Pre-post surveys of general practice teams demonstrated an increase in knowledge (15%) and confidence (25%) in identifying frailty. Use of FRAIL scale increased by 55% and sarcopenia assessments by 47% post-sprint. Medicare Benefits Schedule items for health assessments and care planning remained stable. Patient QOL outcomes for n=121 patients remained stable with QOL utility scores between 72.0-73.6. Practice teams expressed that implementing frailty screening was feasible, however barriers related to lack of time, funding, and patient resistance.
Conclusion
A quality improvement sprint with facilitated support was effective in increasing general practice teams’ knowledge, confidence, and uptake of frailty and sarcopenia screening with older adults.