Grant: Doctoral Research Award: Canada Graduate Scholarships

Frailty is a worldwide problem. Over 1.5 million older adults in Canada are frail and in 10 years this number is expected to reach 2 million. Frailty is a state of increased vulnerability from physical, social, and cognitive factors. It results in greater risk of negative health outcomes such as immobility, falls, and hospitalization. Frailty is best thought of as being on a continuum and can be reversed if caught early. Currently there is no standard way to identify frailty severity. The purpose of this research is to identify the severity of frailty on a continuum in older adults using primary care electronic medical record (EMR) data. This research will address two questions: 1) What is the validity of implementing a frailty severity scale using primary care EMR data? and 2) How is frailty understood from physicians', nurses', and patients' perspectives? This study builds on work completed in the United Kingdom using their electronic frailty index. I will translate electronic terms, called codes, that represent frailty to a coding system used in Canada. I will interview physicians, nurses, and patients to explore their experiences with and thoughts about frailty to determine whether there is agreement on the codes representing frailty. I will then develop a revised electronic frailty index within EMR systems and explore primary care clinicians' experiences with it and its usefulness. This would be the first study in Canada to examine frailty severity using primary care EMR data. This work would be available to more than 1,500 clinicians. The frailty index will support clinicians in helping older adults remain independent and prevent unnecessary hospitalizations associated with frailty. This research aligns with the goals of the Canadian Frailty Network, and with policy directions from the British Columbia Ministry of Health, where early detection of frailty and intervention are prioritized to enhance quality of care and reduce healthcare system spending.