Primary health care professionals' experiences of using the Tilburg Frailty Indicator: an interview study.

Abstract

Aim: The aim of this study was to explore primary health care professionals' (PHCP) experiences of frailty assessment with the Tilburg Frailty Indicator (TFI) with focus on feasibility aspects.

Background: Primary health care (PHC) is often the first point of contact for older people and assessment of frailty is therefore often recommended in this setting. There is however a lack of awareness of frailty in PHC. The TFI has been proposed as a suitable instrument for frailty assessment in PHC. It consists of 25 questions, where ten questions aim to identify risk factors for frailty and 15 questions assess physical, psychological, and social frailty. There are no previous studies of feasibility aspects of TFI in PHC.

Methods: A qualitative interview study with physicians, nurses, and physiotherapists that had used TFI in face-to-face interviews during a care visit. Interviews were transcribed and the text was thematically analyzed using qualitative content analysis.

Findings: Nine interviews were performed. The PHCPs experiences were expressed in one theme: TFI is useful and feasible but requires time and knowledge. TFI was described as easy to use and providing a holistic assessment of the patient. Using the TFI was time-consuming but provided useful information for care planning. In conclusion, the TFI could be a clinically useful tool to assess frailty in PHC. The result indicates a need of educational efforts to increase knowledge about frailty and a need for primary health care to adjust to older people in order to allow care visits to include both assessment and management of frailty.