Rapid evidence review to understand effective frailty care pathways and their components, in primary and community care

Thompson, Juliana, Cook, Glenda, Masterman, Claire, Parkinson, Mark and Bainbridge, Lesley (2022) Rapid evidence review to understand effective frailty care pathways and their components, in primary and community care. International Journal of Health Governance, 27 (1). pp. 54-75. ISSN 2059-4631

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Abstract

Purpose
Different pathways of frailty care to prevent or delay progression of frailty and enable people to live well with frailty are emerging in primary and community care in the UK. The purpose of the study is to understand effective frailty care pathways and their components to inform future service development and pathway evaluation in primary- and community-care services.

Design/methodology/approach
A rapid evidence review was conducted: 11 research publications met the inclusion criteria and were analysed using narrative thematic synthesis.

Findings
There is strong evidence that resistance-based exercise, self-management support, community geriatric services and hospital at home (HAH) improve patient health and function. In general, evaluation and comparison of frailty care pathways, components and pathway operations is challenging due to weaknesses, inconsistencies and differences in evaluation, but it is essential to include consideration of process, determinant and implementation of pathways in evaluations.

Originality/value
To achieve meaningful evaluations and facilitate comparisons of frailty pathways, a standardised evaluation toolkit that incorporates evaluation of how pathways are operated is required for evaluating the impact of frailty pathways of care.

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