We Can’t Address What We Don’t Measure Consistently
CFN and National Institute on Ageing paper explores frailty measurement
More than one million Canadians are living with frailty, but a lack of consistent measurement of the condition is potentially exposing patients to inappropriate care.
Canadian Frailty Network recently commissioned a report from the National Institute on Ageing (NIA) exploring this issue. The NIA/CFN report We Can’t Address What We Don’t Measure Consistently: Building Consensus on Frailty in Canada, authored by Dr. Samir Sinha, Allan McKee, Ivy Wong, Julie Dunning, Michael Nicin, and Dr. John Muscedere, shows that frailty is a common condition more prevalent in older populations, which increases an individual’s risk of falls, emergency department visits, hospitalization, institutionalization, and death. Released September 24, 2018, the report also shows that proactively and consistently measuring frailty can help health care providers better support individuals living with frailty to remain as independent as possible.
The problem, the authors argue, is that frailty is not being measured consistently in Canada, which makes it difficult for health providers and governments to address. Our current health system is fragmented, with everyone gathering different information relevant to frailty, using different assessment tools, and reporting information in different ways. Reliably evaluating care, health outcomes and healthcare resource utilization by older adults living with frailty is close to impossible. Frailty in older adults is under-recognized, under-documented and under-coded in data from medical encounters, hospital discharge summaries and death certificates.
The report urges the research and health care communities to come to consensus on a common definition of frailty, and argues that clinicians need to consider social factors, such as poverty, housing and loneliness, which can contribute to how well individuals cope with frailty.
“Ultimately CFN would like to see all older adults coming into contact with the health-care system proactively screened for the presence of frailty or risk factors for its development” said Dr. John Muscedere, Scientific Director and CEO of the Canadian Frailty Network. “Using scientifically proven tools to identify frailty, proactive models of care and interventions could be put in place to prevent or delay frailty’s development or progression. Care planning would also start early rather than waiting for a crisis, improving outcomes and easing the burden and costs to our health and social care systems.”