Clinical trial NCT04931472: Feasibility and Acceptability of the Clinical Frailty Scale in a Swedish Emergency Department Setting
Official title: Feasibility and Acceptability of the Clinical Frailty Scale in a Swedish Emergency Department Setting
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Frailty
Keywords: Frailty
Geriatric assessment
Emergency service
Feasibility studies
Geriatric emergency medicine
Lead sponsor: University Hospital, Linkoeping
Sponsor class: OTHER
First posted: 2021-06-18
Enrollment: 229
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Physicians, registered nurses and assistant nurses working in the ED

Brief summary: The purpose of this study is to evaluate the feasibility and acceptability of the Clinical Frailty Scale (CFS).

The scale can potentially be adopted for daily use in the Emergency Department (ED) and have been evaluated with regard to feasibility to a certain extent, but have so far not been evaluated in the Swedish emergency care context.

Detailed description: The CFS is introduced and tested as part of a quality-improvement process regarding elderly people within the three Emergency departments (ED) of Region Östergötland.

CFS is a 9-point scale developed within the Canadian Study of Health and Aging, a pictograph and a clinical description aids to assign scores from very fit to terminally ill. The scale enable clinicians to stratify elderly people's degree of frailty with the help of questions and clinical assessment. However, even excellent tools will not be used if they are too difficult or time consuming. The amount of papers addressing issues regarding feasibility and acceptability of the CFS in a clinical ED-setting is still limited, and for Swedish EDs non-existent.

This study is part of a larger research project, data will be collected in three ways:

A. All eligible patients who visit the ED for a period of six weeks will be enrolled, and subsequently assessed with CFS by one of their responsible health-care professionals (i.e. physician, registered nurse or nurse assistant). The number of screened patients divided by the total number of eligible patients will yield the screening rate. Patient- and organisational related characteristics will be collected from the electronic health record.

B. 100 patients will be assessed when someone from the research team is present to enrol patients and clock the assessments. These work shifts will be selected using the online application Research Randomizer, to randomly include all hours of the day as well as eligible health-care professionals. The research-team member will document the time to complete the assessment using CFS, which will give us the screening time.

C. To assess acceptability, health-care professionals will be sent a questionnaire per email, including two reminders. The questionnaire will consist of Likert scales, multiple-choice questions and open textboxes with the aim to explore facilitators and barriers for screening completion.

Primary aim: To explore the feasibility and acceptability of the CFS in a Swedish Emergency care context.

Eligibility criteria: Inclusion Criteria:

* Has been in clinical work at the ED for the period of the current study

Exclusion Criteria:

* Unwilling to provide informed consent

Primary outcomes:
measure: Completion rate
timeFrame: During a period of six weeks
Secondary outcomes:
measure: Duration of time to make the assessment
timeFrame: The assessment will be made in connection with the patient´s first meeting with the care team, i.e. within 1 hour from the patient´s arrival to the ED
measure: Patient related characteristics correlated to completion rate
timeFrame: From admission to discharge from the Emergency department, up to 24 hours.
measure: Organisational related characteristics correlated to completion rate
timeFrame: From admission to discharge from the Emergency department, up to 24 hours
measure: Ease of use
timeFrame: Questionnaire that can be answered within five weeks
measure: Relevance
timeFrame: Questionnaire that can be answered within five weeks
measure: Facilitators to perform assessment
timeFrame: Questionnaire that can be answered within five weeks
measure: Barriers to perform
timeFrame: Questionnaire that can be answered within five weeks
Other outcomes:
Locations:
city: Linköping
country: Sweden
facility: Akutmottagningen US Östergötland
state: Östergötland
Study officials:
References:
citation: Lewis ET, Dent E, Alkhouri H, Kellett J, Williamson M, Asha S, Holdgate A, Mackenzie J, Winoto L, Fajardo-Pulido D, Ticehurst M, Hillman K, McCarthy S, Elcombe E, Rogers K, Cardona M. Which frailty scale for patients admitted via Emergency Department? A cohort study. Arch Gerontol Geriatr. 2019 Jan-Feb;80:104-114. doi: 10.1016/j.archger.2018.11.002. Epub 2018 Nov 8.
citation: Elliott A, Phelps K, Regen E, Conroy SP. Identifying frailty in the Emergency Department-feasibility study. Age Ageing. 2017 Sep 1;46(5):840-845. doi: 10.1093/ageing/afx089.
citation: Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005 Aug 30;173(5):489-95. doi: 10.1503/cmaj.050051.