Feasibility,reliability,validity of an electronic Frailty Index based on Comprehensive Geriatric Assessment in Primary Care

To promote early management of frailty, we developed an electronic Frailty Index based on deficit accumulation in a Comprehensive Geriatric Assessment (eFI-CGA) from electronic health records. Here, we examined the feasibility, reliability, and validity of the eFI-CGA by primary care providers (PCP). <h3>Method :</h3> We enrolled community-dwelling older adults with mild/moderate frailty under the care of Fraser Health and Nova Scotia Health (n=100). A PCP and a geriatrician assessed each patient independently at baseline and six months. PCP and geriatrician inter-rater agreements were tested using the intraclass correlation coefficient (ICC). The eFI-CGA characteristics were also examined <h3>Results:</h3> Ninety-eight percent of the participants completed both PCP and geriatrician assessments at baseline (84 years, 62% women, 59% married currently). The mean eFI-CGA was 0.28±0.11 and 0.29±0.12, which changed insignificantly at follow-up 82% of patients also completed (0.28 ± 0.12 and 0.28 ±0.12). The eFI-CGA scores were correlated (each p&lt;.001) with the Clinical Frailty Scale (CFS) at baseline and follow-up (r≥0.61 by PCP, r?0.70 by geriatrician) and with age (r≥0.44 by PCP, r≥0.45 by geriatrician). The ICC value for the eFI-CGA by PCP and geriatrician was 0.91 at baseline and 0.87 at follow-up, higher than that for CFS (0.76; each p&lt;.001). <h3>Discussion:</h3> The frailty assessments based on eCGA by PCP and geriatricians were highly comparable, suggesting that it is reliable and feasible to assess frailty in primary care using eFI-CGA. <h3>Conclusion:</h3> The study supports the role of eFI-CGA in geriatrilizing primary care for early assessment and management of frailty. Further research will scale up the eFI-CGA implementation and application.