Optimising Outcomes For Those With Chronic Respiratory Disease: Detecting Frailty In The Respiratory OPD

Abstract

Background Frailty is a treatable trait of relevance to people with various chronic respiratory diseases, especially those with severe COPD and/or lung transplantation. This has been recognised in the 2024 GOLD (Global initiative for chronic Obstructive Lung Disease) report and within recent European Respiratory Society guidelines. Central to optimisation of frailty management in those with chronic respiratory conditions is the identification of frail patients in the respiratory OPD (outpatients department) setting. This study aims to assess the prevalence of frailty among patients attending the respiratory OPD in our hospital. Methods A cross-sectional study was conducted over two respiratory clinics over a two-week period. Patients aged 65 and above were screened for frailty using the Clinical Frailty Scale (CFS). A CFS score was assigned to each patient by an assessing NCHD/consultant on the respiratory team. Statistical analysis was then performed to determine the prevalence of frailty amongst such patients. Frailty was defined as those having a CFS score of >5. Results A total of 25 patients were included in the study. Frailty (CFS score of >5) was identified in 56% of patients assessed, with 12% of patients being identified as having a CFS score of 7 (severely frail) or higher. Frailty had not previously been diagnosed by the respiratory team in those patients. Conclusion This study highlights a high prevalence of frailty among patients aged 65 or over in the respiratory OPD. Implementing systematic frailty screening in the respiratory OPD using the CFS can improve early identification of such patients, potentially enhancing management and clinical outcomes. The CFS is a quick and effective tool in identifying frailty. Integrating frailty assessments into routine clinical practice may help to ensure comprehensive care for this vulnerable population. We are currently looking at options for referral pathways to develop to improve management of frailty in this population.