European Collaborative and Interprofessional Capability Framework for Prevention and Management of Frailty—a consensus process supported by the Joint Action for Frailty Prevention (ADVANTAGE) and the European Geriatric Medicine Society (EuGMS)

Roller‐Wirnsberger, Regina; Lindner, Sonja; Liew, Aaron; Ó’Caoimh, Rónán; Koula, Maria-Lamprini; Moody, Dawn; Espinosa, Juan Manuel; Durme, Thérèse Van; Dimitrov, Plamen; Benjak, Tomislav; Nicolaidou, Elena; Hammar, Teija; Vanhecke, Eliane; Junius-Walker, Ulrike; Csizmadia, Péter; Galluzzo, Lucia; Macijauskienė, Jūratė; Salem, Mohamed; Rietman, Liset; Ranhoff, Anette Hylen; Targowski, Tomasz; Arriaga, Miguel; Bozdog, Elena; Gabrovec, Branko; Hendry, Anne; Martin, Finbarr C.; Rodríguez‐Mañas, Leocadio

doi:10.1007/s40520-019-01455-5

Cited by 29 publications

(23 citation statements)

References 16 publications

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“…As a result, COVID-19 patients have frequently been described within the academic discourse as “frail”, with this term being used in its more colloquial sense [ 9 – 11 ]. Furthermore, clinical management guidelines, such as those produced by the UK National Institute for Health and Care Excellence (NICE), typically recommend the assessment of frailty as the initial step when triaging suspected COVID-19 patients [ 12 ], and frailty is also addressed more widely in recent European guidelines [ 13 ]. However, the clinical syndrome of frailty has yet to be formally examined in relation to COVID-19 disease, beyond single case reports [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 and associations with frailty and multimorbidity: a prospective analysis of UK Biobank participants

et al. 2020

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Background Frailty and multimorbidity have been suggested as risk factors for severe COVID-19 disease. Aims We investigated, in the UK Biobank, whether frailty and multimorbidity were associated with risk of hospitalisation with COVID-19. Methods 502,640 participants aged 40–69 years at baseline (54–79 years at COVID-19 testing) were recruited across UK during 2006–10. A modified assessment of frailty using Fried’s classification was generated from baseline data. COVID-19 test results (England) were available for 16/03/2020–01/06/2020, mostly taken in hospital settings. Logistic regression was used to discern associations between frailty, multimorbidity and COVID-19 diagnoses, after adjusting for sex, age, BMI, ethnicity, education, smoking and number of comorbidity groupings, comparing COVID-19 positive, COVID-19 negative and non-tested groups. Results 4510 participants were tested for COVID-19 (positive = 1326, negative = 3184). 497,996 participants were not tested. Compared to the non-tested group, after adjustment, COVID-19 positive participants were more likely to be frail (OR = 1.4 [95%CI = 1.1, 1.8]), report slow walking speed (OR = 1.3 [1.1, 1.6]), report two or more falls in the past year (OR = 1.3 [1.0, 1.5]) and be multimorbid (≥ 4 comorbidity groupings vs 0–1: OR = 1.9 [1.5, 2.3]). However, similar strength of associations were apparent when comparing COVID-19 negative and non-tested groups. However, frailty and multimorbidity were not associated with COVID-19 diagnoses, when comparing COVID-19 positive and COVID-19 negative participants. Discussion and conclusions Frailty and multimorbidity do not appear to aid risk stratification, in terms of positive versus negative results of COVID-19 testing. Investigation of the prognostic value of these markers for adverse clinical sequelae following COVID-19 disease is urgently needed.

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Section: Introductionmentioning

confidence: 99%

COVID-19 and associations with frailty and multimorbidity: a prospective analysis of UK Biobank participants

et al. 2020

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“…Many studies suggest that a patient centered teamwork approach is essential for constructing a high quality, safe and reliable health care delivery system 20 . In this context, a capability framework of core competences for caring frail older people has been developed by experts and was adopted during this meeting 21 . Aiming towards Interprofessional Collaborative Practice (ICP) for care of very frail older people, a cultural change is needed and the group agreed that guidelines should be drafted to facilitate implementation and scaling-up processes within European Member States (MSs).…”

Section: Resultsmentioning

confidence: 99%

From the bench to practice – Field integration of community-based services for older citizens with different levels of functional limitation across European Regions

Liotta

Roller‐Wirnsberger

Iaccarino

et al. 2021

Translational Medicine @ UniSa

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The meeting of the European Innovation Partnership on Active and Healthy Ageing (EIPonAHA) action group A3 together with members of the Reference site collaborative network (RSCN) in December 2019 in Rome focused on integration of evidence-based approaches on health and care delivery for older citizens at different levels of needs with expertise coming from stakeholder across Europe. It was the final aim of the group to co-create culturally sensitive pathways and facilitate co-ownership for further implementation of the pathways in different care systems across Europe. The study design is a mixed method approach. Based on data analysis from a cohort of community-dwelling over-65 citizens in the framework of a longitudinal observational study in Rome, which included health, social and functional capacity data, three personas profiles were developed: the pre-frail, the frail and the very frail personas. Based on these data, experts were asked to co-create care pathways due to evidence and eminence during a workshop and included into a final report. All working groups agreed on a common understanding that integration of care means person-centered integration of health and social care, longitudinally provided across primary and secondary health care including citizens’ individual social, economic and human resources. Elements for consideration during care for pre-frail people are loneliness and social isolation, which, lead to limitation of physical autonomy in the light of reduced access to social support. Frail people need adaption of environmental structures and, again, social resource allocation to maintain at home. Very frail are generally vulnerable patients with complex needs. Most of them remain at home because of a strong individual social support and integrated health care delivery. The approach described in this publication may represent a first approach to scaling-up care delivery in a person-centered approach.

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“…23 Telemedicine could also be implemented within this model of care for example by inviting consulting specialists and primary care providers to partake in multidisciplinary consultations. 21,46 Moreover, the Ear-lySense could also be used to monitor vital signs (ie, respiration and heart rate) from an outside location. 35…”

Section: Discussionmentioning

confidence: 99%

“…The care is delivered at a unit within an intermediate care facility and is led by a geriatrician. 14 We present this model of care in context with other models of care for geriatric patients in Figure 1, which shows how acute geriatric units may fill a gap in care for adults with multiple chronic conditions 19 and frailty 20,21 who need acute care.…”

mentioning

confidence: 99%

Two European Examples of Acute Geriatric Units Located Outside of a General Hospital for Older Adults With Exacerbated Chronic Conditions

Ribbink

Gual

Vroomen

et al. 2021

Journal of the American Medical Directors Association

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Objective: Throughout Europe, the number of older adults requiring acute hospitalization is increasing. Admission to an acute geriatric unit outside of a general hospital could be an alternative. In this model of acute medical care, comprehensive geriatric assessment and rehabilitation are provided to selected older patients. This study aims to compare patients' diagnoses, characteristics, and outcomes of 2 European sites where this care occurs. Design: Exploratory cohort study. Setting and participants: Subacute Care Unit (SCU), introduced in 2012 in Barcelona, Spain, and the Acute Geriatric Community Hospital (AGCH), introduced in 2018 in Amsterdam, the Netherlands. The main admission criteria for older patients were acute events or exacerbations of chronic conditions, hemodynamic stability on admission, and no requirement for complex diagnostics. Measures: We compared setting, characteristics, and outcomes between patients admitted to the 2 units. Results: Data from 909 patients admitted to SCU and 174 to AGCH were available. Patients were admitted from the emergency department or from home. The mean age was 85.8 years [standard deviation (SD) ¼ 6.7] at SCU and 81.9 years (SD ¼ 8.5) (P < .001) at AGCH. At SCU, patients were more often delirious (38.7% vs 22.4%, P < .001) on admission. At both units, infection was the main admission diagnosis. Other diagnoses included heart failure or chronic obstructive pulmonary disease. Five percent or less of patients were readmitted to general hospitals. Average length of stay was 8.8 (SD ¼ 4.4) days (SCU) and 9.9 (SD ¼ 7.5) days (AGCH). Conclusions and Implications: These acute geriatric units are quite similar and both provide an alternative to admission to a general hospital. We encourage the comparison of these units to other examples in Europe and suggest multicentric studies comparing their performance to usual hospital care.

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European Collaborative and Interprofessional Capability Framework for Prevention and Management of Frailty—a consensus process supported by the Joint Action for Frailty Prevention (ADVANTAGE) and the European Geriatric Medicine Society (EuGMS)

Cited by 29 publications

References 16 publications

COVID-19 and associations with frailty and multimorbidity: a prospective analysis of UK Biobank participants

COVID-19 and associations with frailty and multimorbidity: a prospective analysis of UK Biobank participants

From the bench to practice – Field integration of community-based services for older citizens with different levels of functional limitation across European Regions

Two European Examples of Acute Geriatric Units Located Outside of a General Hospital for Older Adults With Exacerbated Chronic Conditions

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