Background
Frailty
RECRUITMENT, EMERGENCY
The number of people over the age of 85 has nearly doubled in the past three decades and it is estimated that by 2030 one in five people in England will be over the age of 65 [Comprehensive Geriatric Assessment (CGA) offers holistic multidisciplinary care for older adults with frailty. CGA takes into account various aspects of a person's health, such as their physical medical condition, mental health, functioning, social circumstances, and environment. This approach is used to create a personalised care plan that involves multiple agencies and disciplines, with specific goals aimed at facilitating discharge planning and minimising unnecessary hospital admissions [Furthermore, accurate and economical screening and identifying suitable candidates for CGA is the first step to avoiding over-or under-prescription. The electronic Frailty Index (eFI) [Once the older adults with frailty are identified, a CGA and subsequent care and support plan could be effectively delivered in the community or patient’s home. However, coordination of multidisciplinary team assessment and care and support plan formulation is impractical because of busy General Practice (GP) Centres; therefore, it is not feasible for anyone with frailty to undergo a full multidisciplinary CGA [This study aimed to explore the feasibility of identifying frail older adults who benefit most from CGA and subsequent implementation of a tailored CGA with care and support plan (CGA & CSP) for older adults with frailty by ANPs. Additionally, it aimed to measure key health-related outcomes, estimate healthcare resource usage, and evaluate patients’ perception of the intervention. In line with this, the objectives were:To assess the feasibility of the study, which includes reporting the study invitation response rate, the eligibility rate (i.e. the number of frail older adults confirmed by nurse’s assessment and clinical judgement), the recruitment rate (i.e. the number of participants who were eligible and randomised), the retention rate (i.e. the number of participants available for interim and final CGA & CSP review) and the dropout rate (i.e. participants not available for post-intervention outcome assessment).To explore whether the intervention (i.e. CGA & CSP) improves key health-related outcome domains such as function, quality of life, and loneliness (see Deviation from protocol).To estimate the utilisation of health care resource usage and expenses related to CGA & CSP delivery. This includes time ANPs spend on CGA & CSP, as well as hospital and nursing home admission, 999 calls, Accident and Emergency department (A&E) attendance, GP Centre, or GP Centre out-of-hour attendance and calls.To evaluate older adults’ perceptions of the CGA & CSP intervention and delivery.