The Feasibility of Deriving the Electronic Frailty Index from Australian General Practice Records

Ebony T. Lewis, Margaret Williamson, Lou Lewis, Danielle Ni Chroinin, Elsa Dent, Maree Ticehurst, Ruth Peters, Rona Macniven, Magnolia Cardona

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Abstract

Purpose: Frailty is a prevalent condition in older adults. Identification of frailty using an electronic Frailty Index (eFI) has been successfully implemented across general practices in the United Kingdom. However, in Australia, the eFI remains understudied. Therefore, we aimed to (i) examine the feasibility of deriving an eFI from Australian general practice records and (ii) describe the prevalence of frailty as measured by the eFI and the prevalence with socioeconomic status and geographic remoteness.
Participants and Methods: This retrospective analysis included patients (≥ 70 years) attending any one of > 700 general practices utilizing the Australian MedicineInsight data platform, 2017– 2018. A 36-item eFI was derived using standard methodology, with frailty classified as mild (scores 0.13– 0.24); moderate (0.25– 0.36) or severe (≥ 0.37). Socioeconomic status (Socio-Economic Indexes for Areas (SEIFA) index)) and geographic remoteness (Australian Statistical Geography Standard (ASGC) remoteness areas) were also examined.
Results: In total, 79,251 patients (56% female) were included, mean age 80.0 years (SD 6.5); 37.4% (95% CI 37.0– 37.7) were mildly frail, 16.7% (95% CI 16.4– 16.9) moderately frail, 4.8% (95% CI 4.7– 5.0) severely frail. Median eFI score was 0.14 (IQR 0.08 to 0.22); maximum eFI score was 0.69. Across all age groups, moderate and severe frailty was significantly more prevalent in females (P < 0.001). Frailty severity increased with increasing age (P < 0.001) and was strongly associated with socioeconomic disadvantage (P < 0.001) but not with geographic remoteness.
Conclusion: Frailty was identifiable from routinely collected general practice data. Frailty was more prevalent in socioeconomically disadvantaged groups, women and older patients and existed in all levels of remoteness. Routine implementation of an eFI could inform interventions to prevent or reduce frailty in all older adults, regardless of location.
Original languageEnglish
Pages (from-to)1589—1598
Number of pages10
JournalClinical Interventions in Aging
Volume17
DOIs
Publication statusPublished - 3 Nov 2022

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