Should frailty assessment be incorporated in COPD Outreach Programmes?

Title: Should frailty assessment be incorporated in COPD Outreach Programmes?
Author(s): D Masterson M O'Connor A Radley Y Vapra K Bolger
Institution: Tipperary University Hospital
Poster: Click to view poster
Category: COPD/Asthma
Abstract: A Sláintecare funded COPD Outreach Programme was commenced in October 2020. COPD Outreach Programmes have been proven to reduce length of stay (LOS), reduce re-admission rates and improve quality of life.
National inclusion and exclusion criteria for COPD Outreach ensure safety is maintained but precise measures to predict who will require readmission, are less robust. Baseline measures such as FEV1, mMRC, CAT, EuroQoL EQ-5D-5L, previous admissions, LOS, and co-morbidities are captured. Our programme includes frailty assessment using the Rockwood Clinical Frailty Scale (CFS).
32 candidates, with a CFS ranging from 3-7, have been enrolled and discharged within 72 hours. 15/32 (47%) have passed the 90 day since acceptance. 7/15 have been readmitted, of which 57% were associated with a CFS-6 which is a moderately frail classification, with the remainder at CFS-5 (mildly frail). These re-admissions utilised 21.5 bed days, compared with 51.5 bed days in the previous 90 days.
This study questions whether frailty scores should be incorporated in inclusion /exclusion criteria. On identification of a frail patient, further resources and interventions could then be made available through the COPD Outreach Programme, to further optimise health outcomes and potentially reduce re-admissions.