General practitioners’ perceptions, attitudes and experiences of frailty and frailty screening

Ambagtsheer, Rachel C.; Archibald, Mandy M.; Mills, David; Yu, Solomon; Beilby, Justin

doi:10.31128/ajgp-11-18-4757

Cited by 36 publications

(57 citation statements)

References 47 publications

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“…The second half of the interview focused on perceptions of frailty screening and a feasibility review of seven validated frailty screening tools (i.e., Edmonton Frail Scale, Groningen Frailty Index (GFI), PRISMA-7, Gait Speed, Timed Up and Go, The Frail Questionnaire, The Kihon Checklist). These specific tools were selected as part of larger program of work including a feasibility and diagnostic test accuracy study of commonly used frailty screening instruments [25], and subsequent qualitative studies with healthcare provider and consumer groups [13,22]. As part of the selection process, a literature review was conducted; 14 tools were shortlisted for deliberation in reference to the tools' validity (i.e., minimum sensitivity of 0.6); contextual appropriateness (i.e., English, relevant to Australian practice context); time to implement (i.e., < 20 min), and administration method (i.e., administered rather than based on health records) [25].…”

Section: Data Collection and Analysismentioning

confidence: 99%

“…Yet, providers' awareness of frailty and perception of its importance to intra and post operative (and ideally, pre-operative) surgical care, as well as the availability and suitability of frailty screening tools for orthopaedic practice settings, are critical and often-overlooked precursors to the adoption of such best practices in the care of older adults with frailty [13]. While a number of qualitative studies have examined perceptions of frailty and frailty screening among the public [13,18], health care provider groups including general practitioners [22], and healthcare policy-makers [23], we are unaware of any study exploring orthopaedic surgeons' perceptions and attitudes towards frailty and frailty screening. Given the growing numbers of frail older people attending hospital with complex care needs, the increased surgical demands in this population [16], and the potential clinical impact of frailty screening in outcome optimization for orthopaedic patients, research is needed to understand provider perspectives of frailty and frailty screening in order to identify barriers to optimal frailty management.…”

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confidence: 99%

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Orthopaedic surgeons’ perceptions of frailty and frailty screening

2020

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Background: Over the past decade, there has been significant growth in the awareness and understanding of fragility among orthopaedic surgeons in the context of osteoporotic fractures and with it, improvements in the recognition and management of fragility fractures. Emerging as a major clinical and research focus in aged care is the concept of frailty and its associations with fragility, sarcopenia, falls and rehabilitation. Currently, research is lacking on how orthopaedic surgeons perceive frailty and the role of frailty screening. A baseline understanding of these perceptions is needed to inform integration of frailty identification and management for patient optimization in orthopaedic practices, as well as research and education efforts of patients and healthcare professionals in orthopaedic contexts. Methods:We used an exploratory design guided by qualitative description to conduct 15 semi-structured telephone and in-person interviews across three orthopaedic surgeon subgroups (Registrars, Junior Consultants, and Senior Consultants). Data collection and analysis occurred iteratively and was guided by thematic saturation.Results: Orthopaedic surgeons have a disparate understanding of frailty. Between colleagues, frailty is often referred to non-specifically to suggest a general state of risk to the patient. Frailty screening is regarded positively but its specific utility in orthopaedic environments is questioned. Easy-to-administer frailty screening tools that are not exclusive assessments of functional status are viewed most satisfactorily. However these tools are rarely used. Conclusions: There is little understanding among orthopaedic surgeons of frailty as a phenotype. Beliefs around modifiability of frailty were dissimilar as were the impact of related risk factors, such a cognitive status, chronic disease, social isolation, and environmental influences. This in turn may significantly impact on the occurrence and treatment outcomes of fragility fracture, a common orthopaedic problem in older populations. This study highlights need for knowledge translation efforts (e.g. education) to achieve cohesive understanding of frailty among health professionals.

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Orthopaedic surgeons’ perceptions of frailty and frailty screening

2020

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“…It is important that acute care providers are prepared to recognise and appropriately respond to the needs of frail older patients who are vulnerable to sudden and dramatic changes in health and medical complications (e.g., delirium, urinary tract infection, sepsis) triggered by seemingly insignificant events such as a change in medication or an infection [16,17]. A number of qualitative studies have examined perceptions of frailty and frailty screening among the public [18,19], health care provider groups including general practitioners [20], and healthcare policy-makers [21]. Yet we are unaware of any study that has explored orthopaedic surgeons' perceptions and attitudes towards frailty and frailty screening.…”

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confidence: 99%

Orthopaedic Surgeons Perceptions of Frailty and Frailty Screening

Archibald

Lawless

Gill

et al. 2019

Preprint

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Section: Introductionmentioning

confidence: 99%

Orthopaedic Surgeons Perceptions of Frailty and Frailty Screening

Archibald

Lawless

Gill

et al. 2019

Preprint

Self Cite

View full text Add to dashboard Cite

Background Over the past decade, there has been significant growth in the awareness and understanding of fragility among orthopaedic surgeons in the context of osteoporotic fractures and with it, improvements in the recognition and management of fragility fractures. Emerging as a major clinical and research focus in aged care is the concept of frailty and its associations with fragility, sarcopenia, falls and rehabilitation. Currently, research is lacking on how orthopaedic surgeons perceive frailty and the role of frailty screening. A baseline understanding of these perceptions is needed to inform integration of frailty identification and management for patient optimization in orthopaedic practices, as well as research and education efforts of patients and healthcare professionals in orthopaedic contexts. Methods We used an exploratory design guided by qualitative description to conduct 15 semi-structured telephone and in-person interviews across three orthopaedic surgeon subgroups (Registrars, Junior and Senior Consultants). Data collection and analysis occurred iteratively and was guided by thematic saturation. Results Orthopaedic surgeons have a disparate understanding of frailty. Between colleagues, frailty is often referred to non-specifically to suggest a general state of risk to the patient. Frailty screening is regarded positively but its specific utility in orthopaedic environments is questioned. Easy-to-administer frailty screening tools that are not exclusive assessments of functional status are viewed most satisfactorily. However these tools are rarely used. Conclusions There is little understanding among orthopaedic surgeons of frailty as a phenotype. Beliefs around modifiability of frailty were dissimilar as were the impact of related risk factors, such a cognitive status, chronic disease, social isolation, and environmental influences. This in turn may significantly impact on the occurrence and treatment outcomes of fragility fracture, a common orthopaedic problem in older populations. This study highlights need for knowledge translation efforts (e.g. education) to achieve cohesive understanding of frailty among health professionals.

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General practitioners’ perceptions, attitudes and experiences of frailty and frailty screening

Cited by 36 publications

References 47 publications

Orthopaedic surgeons’ perceptions of frailty and frailty screening

Orthopaedic surgeons’ perceptions of frailty and frailty screening

Orthopaedic Surgeons Perceptions of Frailty and Frailty Screening

Orthopaedic Surgeons Perceptions of Frailty and Frailty Screening

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