Reversing frailty levels in primary care using the CARES model

Olga Theou; Grace H. Park; Antonina Garm; Xiaowei Song; Barry Clarke; Kenneth Rockwood

doi:10.5770/cgj.20.274

Reversing frailty levels in primary care using the CARES model

Olga Theou, Grace H. Park, Antonina Garm, Xiaowei Song, Barry Clarke, Kenneth Rockwood

Research output: Contribution to journal › Article › peer-review

37 Citations (Scopus)

Abstract

Background The purpose of this manuscript was to evaluate the effectiveness of the Community Actions and Resources Empowering Seniors (CARES) model in measuring and mitigating frailty among community-dwelling older adults. Methods The CARES model is based on a goal-oriented multidisciplinary primary care plan which combines a comprehensive geriatric assessment (CGA) with health coaching. A total of 51 older adults (82 ± 7 years; 33 females) participated in the pilot phase of this initiative. Frailty was measured using the Clinical Frailty Scale (CFS) and the Frailty Index (FI-CGA) at baseline and at six-month follow-up. Results The FI-CGA at follow-up (0.21 ± 0.08) was significantly lower than the FI-CGA at baseline (0.24 ± 0.08), suggesting an average reduction of 1.8 deficits. Sixty-one per cent of participants improved their FI-CGA and 38% improved CFS categories. Participants classified as vulnerable/frail at baseline were more responsive to the intervention compared to non-frail participants. Conclusion Pilot data showed that it is feasible to assess frailty in primary care and that the CARES intervention might have a positive effect on frailty, a promising finding that requires further investigations. General practitioners who participate in the CARES model can now access their patients' FI-CGA scores at point of service through their electronic medical records.

Original language	English
Pages (from-to)	105-111
Number of pages	7
Journal	Canadian Geriatrics Journal
Volume	20
Issue number	3
DOIs	https://doi.org/10.5770/cgj.20.274
Publication status	Published - Sept 2017

Bibliographical note

Funding Information:
The CARES initiative was funded by The Canadian Foundation for Healthcare improvements EXTRA program. The secondary analysis of this initiative was supported by the Fountain Family Innovation Fund, a philanthropic award administered via the QEII Health Sciences Center Foundation. Additional funding for open access publications was provided from Fraser Health Authority. The authors acknowledge the assistance of Ms. Miranda McMillan who provided the secondary analysis of this project.

Publisher Copyright:
© 2017 Author(s).

ASJC Scopus Subject Areas

Gerontology
Geriatrics and Gerontology

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10.5770/cgj.20.274

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title = "Reversing frailty levels in primary care using the CARES model",

abstract = "Background The purpose of this manuscript was to evaluate the effectiveness of the Community Actions and Resources Empowering Seniors (CARES) model in measuring and mitigating frailty among community-dwelling older adults. Methods The CARES model is based on a goal-oriented multidisciplinary primary care plan which combines a comprehensive geriatric assessment (CGA) with health coaching. A total of 51 older adults (82 ± 7 years; 33 females) participated in the pilot phase of this initiative. Frailty was measured using the Clinical Frailty Scale (CFS) and the Frailty Index (FI-CGA) at baseline and at six-month follow-up. Results The FI-CGA at follow-up (0.21 ± 0.08) was significantly lower than the FI-CGA at baseline (0.24 ± 0.08), suggesting an average reduction of 1.8 deficits. Sixty-one per cent of participants improved their FI-CGA and 38% improved CFS categories. Participants classified as vulnerable/frail at baseline were more responsive to the intervention compared to non-frail participants. Conclusion Pilot data showed that it is feasible to assess frailty in primary care and that the CARES intervention might have a positive effect on frailty, a promising finding that requires further investigations. General practitioners who participate in the CARES model can now access their patients' FI-CGA scores at point of service through their electronic medical records.",

author = "Olga Theou and Park, {Grace H.} and Antonina Garm and Xiaowei Song and Barry Clarke and Kenneth Rockwood",

note = "Funding Information: The CARES initiative was funded by The Canadian Foundation for Healthcare improvements EXTRA program. The secondary analysis of this initiative was supported by the Fountain Family Innovation Fund, a philanthropic award administered via the QEII Health Sciences Center Foundation. Additional funding for open access publications was provided from Fraser Health Authority. The authors acknowledge the assistance of Ms. Miranda McMillan who provided the secondary analysis of this project. Publisher Copyright: {\textcopyright} 2017 Author(s).",

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AU - Clarke, Barry

AU - Rockwood, Kenneth

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N2 - Background The purpose of this manuscript was to evaluate the effectiveness of the Community Actions and Resources Empowering Seniors (CARES) model in measuring and mitigating frailty among community-dwelling older adults. Methods The CARES model is based on a goal-oriented multidisciplinary primary care plan which combines a comprehensive geriatric assessment (CGA) with health coaching. A total of 51 older adults (82 ± 7 years; 33 females) participated in the pilot phase of this initiative. Frailty was measured using the Clinical Frailty Scale (CFS) and the Frailty Index (FI-CGA) at baseline and at six-month follow-up. Results The FI-CGA at follow-up (0.21 ± 0.08) was significantly lower than the FI-CGA at baseline (0.24 ± 0.08), suggesting an average reduction of 1.8 deficits. Sixty-one per cent of participants improved their FI-CGA and 38% improved CFS categories. Participants classified as vulnerable/frail at baseline were more responsive to the intervention compared to non-frail participants. Conclusion Pilot data showed that it is feasible to assess frailty in primary care and that the CARES intervention might have a positive effect on frailty, a promising finding that requires further investigations. General practitioners who participate in the CARES model can now access their patients' FI-CGA scores at point of service through their electronic medical records.

AB - Background The purpose of this manuscript was to evaluate the effectiveness of the Community Actions and Resources Empowering Seniors (CARES) model in measuring and mitigating frailty among community-dwelling older adults. Methods The CARES model is based on a goal-oriented multidisciplinary primary care plan which combines a comprehensive geriatric assessment (CGA) with health coaching. A total of 51 older adults (82 ± 7 years; 33 females) participated in the pilot phase of this initiative. Frailty was measured using the Clinical Frailty Scale (CFS) and the Frailty Index (FI-CGA) at baseline and at six-month follow-up. Results The FI-CGA at follow-up (0.21 ± 0.08) was significantly lower than the FI-CGA at baseline (0.24 ± 0.08), suggesting an average reduction of 1.8 deficits. Sixty-one per cent of participants improved their FI-CGA and 38% improved CFS categories. Participants classified as vulnerable/frail at baseline were more responsive to the intervention compared to non-frail participants. Conclusion Pilot data showed that it is feasible to assess frailty in primary care and that the CARES intervention might have a positive effect on frailty, a promising finding that requires further investigations. General practitioners who participate in the CARES model can now access their patients' FI-CGA scores at point of service through their electronic medical records.

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Reversing frailty levels in primary care using the CARES model

Abstract

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