- Title
- Clinician Estimates of Frailty Compared to Formal Frailty Assessment in Adults With Heart Failure: A Cross-Sectional Analysis
- Creator
- McDonagh, Julee; Prichard, Roslyn; Ferguson, Caleb; Phillips, Jane L.; Davidson, Patricia M.; Macdonald, Peter S.; Newton, Philip J.
- Relation
- Heart, Lung and Circulation Vol. 31, Issue 9, p. 1241-1246
- Publisher Link
- http://dx.doi.org/10.1016/j.hlc.2022.04.003
- Publisher
- Elsevier Australia
- Resource Type
- journal article
- Date
- 2022
- Description
- Background: Frailty assessment is recommended for patients with heart failure. Despite the availability of instruments to assess frailty, there are no clear recommendations regarding the optimal instrument to use in a heart failure context. This ambiguity combined with a lack of education and resources, often leads clinicians to rely on subjective estimates of frailty, such as ‘the end-of-the-bed’ or ‘eyeball’ test. Aim: To examine the association between clinician-estimated frailty and formal frailty assessment in adults with heart failure. Methods: Cross-sectional analysis of the FRAilty MEasurement in Heart Failure (FRAME-HF) study. Participants: (1) Adults aged ≥18 years in the outpatient heart failure clinic and cardiology ward; (2) and cardiovascular clinicians (nurses, physicians, and allied-health professionals). Following participant recruitment, cardiovascular clinicians were asked to rate the participant’s frailty status based on their routine clinical assessment as either: frail, pre-frail, or non-frail, which was then compared to a formal frailty assessment using a modified version of the Frailty Phenotype. The association between clinician-estimated frailty and formal frailty assessment were examined using a weighted Kappa statistic and Spearman’s correlation coefficient. Results: A total of 75 patients and 39 clinicians were recruited, producing 194 paired frailty assessments. Mean age of the patients was 54 (±13) years. Correlation of pooled clinician-estimated frailty to formal frailty was fair (0.52, p=0.00). Correlation was highest between allied-health estimated frailty and formal frailty (0.70, p=0.00). Agreement between pooled clinician-estimated frailty and formal frailty was fair (0.33) and was highest between allied health-estimated frailty and formal frailty (0.45). Conclusion: Subjective clinician-estimated frailty is not a reliable replacement for formal frailty assessment in adults with heart failure, underscoring the need for assessment using a valid and reliable instrument.
- Subject
- heart failure; fraility; frail elderly; frailty assessment; frailty instrument
- Identifier
- http://hdl.handle.net/1959.13/1484724
- Identifier
- uon:51406
- Identifier
- ISSN:1443-9506
- Language
- eng
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