Incorporating the Clinical Frailty Scale into routine outpatient nephrology practice: an observational study of feasibility and associations.
Intern Med J
; 51(8): 1269-1277, 2021 Aug.
Article
em En
| MEDLINE
| ID: mdl-32390289
ABSTRACT
BACKGROUND:
There is an unmet need for routine and accurate prognostication of older adults with end-stage kidney disease (ESKD) and subsequently inadequate advance care planning. Frailty, a clinical syndrome of increased vulnerability, is predictive of adverse health outcomes in the renal population. We propose the Clinical Frailty Scale (CFS) as a feasible tool for routine use in the nephrology outpatient setting to address this unmet need.AIMS:
To assess feasibility and associations of incorporating CFS assessment into routine outpatient nephrology practice in the pre-dialysis setting.METHODS:
CFS was integrated into the outpatient nephrology clinic proforma. A convenience sample of 138 patients aged >50 years, with estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 , attending the outpatient service between September 2018 and April 2019 was included.RESULTS:
Eighty-one CFS assessments were completed by nephrologists, nephrology advanced trainees and clinical nurse specialists. CFS completion rates were 79% from the multidisciplinary Low Clearance Clinic and 41% from nurse-led Pre-dialysis Education Clinic. Planned modality of ESKD management varied with degree of frailty (P < 0.001). 21% of patients who had CFS completed were planned for Conservative Management of ESKD, in contrast to only 5% of those who did not have CFS assessment completed (P < 0.001).CONCLUSION:
Frailty assessment via CFS was feasible in outpatient practice when integrated into routine clinical assessment in a dedicated clinic. Planned ESKD management varied with the degree of frailty. Completion of frailty assessment, when compared with non-completion, appears to be associated with increased planned conservative management of ESKD.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fragilidade
/
Falência Renal Crônica
/
Nefrologia
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Humans
Idioma:
En
Revista:
Intern Med J
Assunto da revista:
MEDICINA INTERNA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Austrália