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

• Published in: Clinical interventions in aging 2022-01, Vol.17, p.1589-1598
• Main Authors: Lewis, Ebony T, Williamson, Margaret, Lewis, Lou P, Chroinin, Danielle Ni, Dent, Elsa, Ticehurst, Maree, Peters, Ruth, Macniven, Rona, Cardona, Magnolia
• Format: Article
• Language: English
• Subjects: aged; Care and treatment; Chronic illnesses; Demographic aspects; Electronic health records; Electronic records; family practice; Frail elderly; Frailty; Geriatric assessment; Health informatics; Medical records; Methods; Older people; Original Research; Primary care; primary health care; Socioeconomic factors; Statistics
• ISSN: 1178-1998; 1176-9092; 1178-1998
• DOI: 10.2147/CIA.S384691

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 ([greater than or equal to]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 ([greater than or equal to]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 identifable 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. Keywords: primary health care, family practice, frailty, electronic health records, geriatric assessment, aged