Presentation Title: 
The best tool to assess frailty in general practice and rural communities
Group Letter: 

Dr Catriona Arnold-Nott (MBBS FRACGP) is a GP currently working in Malanda in the Atherton Tablelands. She graduated from the University of Sydney and did her early hospital years in Darwin. This was followed by a stint working as a volunteer for AVI in Vanuatu, where she and Peter were the only doctors for a province of 25,000 people. Catriona returned to the top end of the Northern Territory to do her GP training, and it was there that Catriona and Peter had their three children Grace, Reuben and Mimi. Looking for a bit more adventure, the young family moved to Thursday Island for four years. They have now settled in the Atherton Tablelands where they live on a farm and raise cattle and strive to grow as much of their own food as they can. Catriona is passionate about compassionate medical care and she really enjoys training registrars and students.

Abstract Text: 

Relevance: People living in rural and regional areas are older, have poorer health status and access to health services compared to those living in metropolitan areas. The design of health services should be informed by accurate health data for the community served. The concept of frailty has been used to assess the risk of morbidity and mortality in older people and could be a useful tool in such data collection. Frailty is related to the ageing process as an accelerated decline in the ability of body systems to respond and recover to physical insult. The more frail the individual, the higher their risk of morbidity and mortality. Frailty assessment is used by General Practitioners internationally to identify older people at risk of poor health outcomes who may benefit from targeted health interventions.

Data on frailty in a community could inform policy for rural health. The use of a frailty assessment tool would enable rural General Practitioners to identify frail clients in their practices. There is currently no consensus on the best tool with which to assess frailty. This presentation will report on a review of the literature to inform selection of a validated frailty assessment tool for use in frailty assessment in General Practice and rural and remote communities.

Aim: To investigate available tools to assess frailty and to consider which would be most useful for rural and remote communities, and in General Practice.

Methods: Medline, OVID, CINAHL, and AUSTHealth were searched using the terms rural, health assessment, Family Physician, primary care, General Practitioner and Australia in conjunction with frailty. Researchers read the abstracts and selected relevant papers from this list and then read the full texts. This literature provided the background on frailty research and identified the assessment tools used to identify frailty.

Results: There are over 20 tools to identify or detect frailty and no gold standard. Frailty screening tools have been used in a variety of settings including the community and rural areas. The Edmonton Frail Scale, which has frequently been used in primary care, is a multi-dimensional validated frailty assessment tool which does not require specialist equipment or training, and is easy to use. The researchers identified this tool to be the most appropriate validated tool to use in a rural General Practice. With this knowledge, the authors are piloting the introduction of a frailty assessment in a rural general practice.