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Publication - Dr Ben Davies

    Frailty assessment in primary health care and its association with unplanned secondary care use

    a rapid review


    Davies, B, Baxter, H, Rooney, J, Simons, P, Sephton, A, Purdy, S & Huntley, A, 2018, ‘Frailty assessment in primary health care and its association with unplanned secondary care use: a rapid review’. British Journal of General Practice Open.


    Background: The growing frail elderly population is increasing pressure on hospital services; this is directing the attention of clinical commissioning groups towards more comprehensive approaches of managing frailty in the primary health care environment.

    Aim: To review the literature on whether assessment of frailty in primary health care leads to a reduction in unplanned secondary care use.

    Design and setting: A rapid review involving a systematic search of Medline and Medline in process.

    Method: Relevant data were extracted following the iterative screening of titles, abstracts and full texts to identify studies in the primary/community healthcare setting which assessed the effect of frailty on unplanned secondary care use from January 2005 - June 2016.

    Results: The review included 11 primary studies: nine observational studies; one randomised controlled trial (RCT) and one non-randomised controlled trial. Eight out of nine observational studies reported a positive association between frailty and secondary care utilisation. The trial evidence reported conflicting findings.

    Conclusion: Older people identified as frail in a primary healthcare setting were more likely to be admitted to hospital. Based on the limited and equivocal trial evidence, it is not possible to draw firm conclusions regarding appropriate tools for the identification and management of frail elderly at risk of hospital admission

    Full details in the University publications repository