When the British Geriatrics Society’s journal Age and Ageing published the first Electronic Frailty Index (eFI) in 2016, it quickly became highly influential and is now used nationally across the NHS to identify and measure frailty within a population. While revolutionary, the original eFI was not without limitations.
The updated Electronic Frailty Index 2 (eFI2) has now been published in Age and Ageing, the international clinical geriatrics journal of the British Geriatrics Society. The eFI2 further advances care for older people with frailty and sets a new standard for frailty research internationally. eFI2 uses existing medical data to identify older people who are at combined risk of key frailty-related outcomes: requiring new home care, having a serious fall, being admitted to a care home; and dying within the next 12 months.
In an advance on the original eFI, it does this by applying ‘weights’ to 36 clinical signs, symptoms, diseases and impairments to calculate an overall eFI2 score. The eFI2 score can then be used to put measures in place to sustain independence for older people living with frailty, such as Comprehensive Geriatric Assessment.
Frailty is a word that is often misunderstood, but what it means is that someone’s resilience is depleted and their recovery from injury or illness can take longer or be more difficult. The eFI2 has been included in the NHS England Proactive Care Framework to help identify people for proactive multidisciplinary care, as part of a more holistic approach to help build resilience. Early intervention can help to delay the progression of frailty, and the eFI2 offers a digital innovation to support this for older people living at home.
Lead author Andy Clegg said:
We are excited to see the eFI2 being made available in UK GP electronic health record systems and included in NHS policy. Frailty is a treatable condition, but left undiagnosed, it can lead to adverse health outcomes. Older people will benefit from the use of the eFI2 in the community to support proactive frailty identification and management. It is great to see the updated index being used to help transform care for older people and manage these risks associated with frailty.
The eFI2 development and implementation was a major team effort. We would also like to thank the NIHR Applied Research Collaboration in Yorkshire & Humber, and North Thames, for funding and supporting this important work.”
