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Busnel Catherine, Perrier-Gros-Claude Olivier, Ludwig Catherine (2020), Évaluer la fragilité dans les pratiques de soins : brefs rappels à la lumière de la pandémie de Covid-19 [Assessing frailty in care practices : quick reminders in the light of the Covid-19 pandemic], in Revue medicale suisse
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Ludwig Catherine, Busnel Catherine (2020), Derivation of a Frailty Index from the interRAI-HC to Assess Frailty among Older Adults Receiving Home Care and Assistance (the “fraXity” Study), in Advances in Geriatric Medicine and Research
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Étude fraXity : Enquête sur la fragilité et complexité des personnes bénéficiaires d’aides/de soins à domicile
||Ludwig, Catherine; Busnel, Catherine; Bontemps, Sophie; Burckhardt, Tobias; Cennamo, Michael; Verissimo, Debora
|Persistent Identifier (PID)
The dataset contains the raw, cleaned and coded data for all measurement occasions of the fraXity study. The set contains 2248 variables, collected for the 223/231 participants who gave informed written consent for data reuse. For the data collected with standardized instruments (e.g. inter-RAI HC, EQ5D, SWLS, MNA-SF), variable coding is done according to published guidelines. The frailty index and the complexity index - the two major outcomes of the study - are also provided in the dataset.
Like most industrialized countries, Switzerland is witnessing population aging and increasing rates of chronic diseases and comorbidities, with resulting widening arrays of care needs among older citizens. In this context, two major challenges need to be addressed. The first is early screening of individuals at risk of functional decline to immediately engage targeted preventive intervention. The second is early identification of patients with complex care needs to rapidly adjust care plans and prevent undesirable health outcomes. In the face of these challenges, clinicians and scholars call for the early screening of frailty and complexity and recommend it as a critical step in preventive and long-term care strategies devoted to elders. As such, early screening should also contribute to reduce costs, both for the individuals and for the health system.In Switzerland, health policies foster shorter hospital stays to the benefit of “aging in place.” In such a system, homecare professionals are key actors in warranting that adapted care is delivered to aging individuals. At present, homecare nurses already contribute to this endeavor by routinely identifying care needs and by delivering individualized care plans. In everyday practice, many homecare nurses use the Resident Assessment Instrument-Home Care (RAI-HC), a comprehensive geriatric assessment tool specifically dedicated to identifying care needs. Yet, recent evidence suggests that the RAI-HC could further be used to derive compound scores with a high clinical value, among them, estimates of frailty. These encouraging findings offer new opportunities to provide RAI-HC users with screening tools acknowledged as useful means for health professionals willing to enhance care in aging populations. The purpose of the present project is to develop frailty and complexity computation algorithms based on the RAI-HC and, in doing so, to provide homecare nurses with valid and reliable screening tools for their routine practice. By relying on a prospective observational case-control longitudinal study, the project intends to assess the predictive validity of the proposed indices with respect to undesirable health outcomes. Repeated measurement occasions, separated by 6-month intervals, will also allow for estimation of intra-individual change in frailty and complexity. In the study, elders living in the community and aged 65 or older are the target population, and three samples will be considered based on the a priori risks of adverse outcomes. These groups will be compared on the observed rates of frailty and complexity and on their evolution over time. Results will allow for identification of subgroups of the aged population for whom early screening of frailty and complexity appears most relevant. Based on the findings, practice guideline will be proposed. They will entail the interpretation of the scores and recommendations for mounting adapted preventive strategies. Finally, the project will contribute to enhancing knowledge on the relation between frailty, a well-known concept in gerontology, and complexity, a concept increasingly referred to in the care literature but that still deserves operational and consensual definitions. The identification of frail elders and individuals with complex needs is of utter importance for health professionals concerned by the quality of care delivered to aging patients. By providing homecare nurses with frailty and complexity screening tools and recommendations for use, this project intends to outfit key actors of the Swiss health system with means to enhance their part in a collective endeavor targeting best care and best quality of life for our aged citizens