Understanding frailty: a qualitative study of European healthcare policy-makers’ approaches to frailty screening and management
ObjectiveTo elicit European healthcare policy-makers’ views, understanding and attitudes about the implementation of frailty screening and management strategies and responses to stakeholders’ views.DesignThematic analysis of semistructured qualitative interviews.SettingEuropean healthcare policy dep...
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| Published in | BMJ open Vol. 8; no. 1; p. e018653 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
BMJ Publishing Group LTD
01.01.2018
BMJ Publishing Group |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2044-6055 2044-6055 |
| DOI | 10.1136/bmjopen-2017-018653 |
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| Abstract | ObjectiveTo elicit European healthcare policy-makers’ views, understanding and attitudes about the implementation of frailty screening and management strategies and responses to stakeholders’ views.DesignThematic analysis of semistructured qualitative interviews.SettingEuropean healthcare policy departments.ParticipantsSeven European healthcare policy-makers representing the European Union (n=2), UK (n=2), Italy (n=1), Spain (n=1) and Poland (n=1). Participants were sourced through professional networks and the European Commission Authentication Service website and were required to be in an active healthcare policy or decision-making role.ResultsSeven themes were identified. Our findings reveal a ‘knowledge gap’, around frailty and awareness of the malleability of frailty, which has resulted in restricted ownership of frailty by specialists. Policy-makers emphasised the need to recognise frailty as a clinical syndrome but stressed that it should be managed via an integrated and interdisciplinary response to chronicity and ageing. That is, through social co-production. This would require a culture shift in care with redeployment of existing resources to deliver frailty management and intervention services. Policy-makers proposed barriers to a culture shift, indicating a need to be innovative with solutions to empower older adults to optimise their health and well-being, while still fully engaging in the social environment. The cultural acceptance of an integrated care system theme described the complexities of institutional change management, as well as cultural issues relating to working democratically, while in signposting adult care, the need for a personal navigator to help older adults to access appropriate services was proposed. Policy-makers also believed that screening for frailty could be an effective tool for frailty management.ConclusionsThere is potential for frailty to be managed in a more integrated and person-centred manner, overcoming the challenges associated with niche ownership within the healthcare system. There is also a need to raise its profile and develop a common understanding of its malleability among stakeholders, as well as consistency in how and when it is measured. |
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| AbstractList | ObjectiveTo elicit European healthcare policy-makers’ views, understanding and attitudes about the implementation of frailty screening and management strategies and responses to stakeholders’ views.DesignThematic analysis of semistructured qualitative interviews.SettingEuropean healthcare policy departments.ParticipantsSeven European healthcare policy-makers representing the European Union (n=2), UK (n=2), Italy (n=1), Spain (n=1) and Poland (n=1). Participants were sourced through professional networks and the European Commission Authentication Service website and were required to be in an active healthcare policy or decision-making role.ResultsSeven themes were identified. Our findings reveal a ‘knowledge gap’, around frailty and awareness of the malleability of frailty, which has resulted in restricted ownership of frailty by specialists. Policy-makers emphasised the need to recognise frailty as a clinical syndrome but stressed that it should be managed via an integrated and interdisciplinary response to chronicity and ageing. That is, through social co-production. This would require a culture shift in care with redeployment of existing resources to deliver frailty management and intervention services. Policy-makers proposed barriers to a culture shift, indicating a need to be innovative with solutions to empower older adults to optimise their health and well-being, while still fully engaging in the social environment. The cultural acceptance of an integrated care system theme described the complexities of institutional change management, as well as cultural issues relating to working democratically, while in signposting adult care, the need for a personal navigator to help older adults to access appropriate services was proposed. Policy-makers also believed that screening for frailty could be an effective tool for frailty management.ConclusionsThere is potential for frailty to be managed in a more integrated and person-centred manner, overcoming the challenges associated with niche ownership within the healthcare system. There is also a need to raise its profile and develop a common understanding of its malleability among stakeholders, as well as consistency in how and when it is measured. To elicit European healthcare policy-makers' views, understanding and attitudes about the implementation of frailty screening and management strategies and responses to stakeholders' views.OBJECTIVETo elicit European healthcare policy-makers' views, understanding and attitudes about the implementation of frailty screening and management strategies and responses to stakeholders' views.Thematic analysis of semistructured qualitative interviews.DESIGNThematic analysis of semistructured qualitative interviews.European healthcare policy departments.SETTINGEuropean healthcare policy departments.Seven European healthcare policy-makers representing the European Union (n=2), UK (n=2), Italy (n=1), Spain (n=1) and Poland (n=1). Participants were sourced through professional networks and the European Commission Authentication Service website and were required to be in an active healthcare policy or decision-making role.PARTICIPANTSSeven European healthcare policy-makers representing the European Union (n=2), UK (n=2), Italy (n=1), Spain (n=1) and Poland (n=1). Participants were sourced through professional networks and the European Commission Authentication Service website and were required to be in an active healthcare policy or decision-making role.Seven themes were identified. Our findings reveal a 'knowledge gap', around frailty and awareness of the malleability of frailty, which has resulted in restricted ownership of frailty by specialists. Policy-makers emphasised the need to recognise frailty as a clinical syndrome but stressed that it should be managed via an integrated and interdisciplinary response to chronicity and ageing. That is, through social co-production. This would require a culture shift in care with redeployment of existing resources to deliver frailty management and intervention services. Policy-makers proposed barriers to a culture shift, indicating a need to be innovative with solutions to empower older adults to optimise their health and well-being, while still fully engaging in the social environment. The cultural acceptance of an integrated care system theme described the complexities of institutional change management, as well as cultural issues relating to working democratically, while in signposting adult care, the need for a personal navigator to help older adults to access appropriate services was proposed. Policy-makers also believed that screening for frailty could be an effective tool for frailty management.RESULTSSeven themes were identified. Our findings reveal a 'knowledge gap', around frailty and awareness of the malleability of frailty, which has resulted in restricted ownership of frailty by specialists. Policy-makers emphasised the need to recognise frailty as a clinical syndrome but stressed that it should be managed via an integrated and interdisciplinary response to chronicity and ageing. That is, through social co-production. This would require a culture shift in care with redeployment of existing resources to deliver frailty management and intervention services. Policy-makers proposed barriers to a culture shift, indicating a need to be innovative with solutions to empower older adults to optimise their health and well-being, while still fully engaging in the social environment. The cultural acceptance of an integrated care system theme described the complexities of institutional change management, as well as cultural issues relating to working democratically, while in signposting adult care, the need for a personal navigator to help older adults to access appropriate services was proposed. Policy-makers also believed that screening for frailty could be an effective tool for frailty management.There is potential for frailty to be managed in a more integrated and person-centred manner, overcoming the challenges associated with niche ownership within the healthcare system. There is also a need to raise its profile and develop a common understanding of its malleability among stakeholders, as well as consistency in how and when it is measured.CONCLUSIONSThere is potential for frailty to be managed in a more integrated and person-centred manner, overcoming the challenges associated with niche ownership within the healthcare system. There is also a need to raise its profile and develop a common understanding of its malleability among stakeholders, as well as consistency in how and when it is measured. To elicit European healthcare policy-makers' views, understanding and attitudes about the implementation of frailty screening and management strategies and responses to stakeholders' views. Thematic analysis of semistructured qualitative interviews. European healthcare policy departments. Seven European healthcare policy-makers representing the European Union (n=2), UK (n=2), Italy (n=1), Spain (n=1) and Poland (n=1). Participants were sourced through professional networks and the European Commission Authentication Service website and were required to be in an active healthcare policy or decision-making role. Seven themes were identified. Our findings reveal a 'knowledge gap', around frailty and which has resulted in restricted by specialists. Policy-makers emphasised the need to recognise frailty as a clinical syndrome but stressed that it should be managed via an integrated and interdisciplinary response to chronicity and ageing. That is, through social co-production. This would require a with redeployment of existing resources to deliver frailty management and intervention services. Policy-makers proposed indicating a need to be innovative with solutions to empower older adults to optimise their health and well-being, while still fully engaging in the social environment. The theme described the complexities of institutional change management, as well as cultural issues relating to working democratically, while in , the need for a personal navigator to help older adults to access appropriate services was proposed. Policy-makers also believed that could be an effective tool for frailty management. There is potential for frailty to be managed in a more integrated and person-centred manner, overcoming the challenges associated with niche ownership within the healthcare system. There is also a need to raise its profile and develop a common understanding of its malleability among stakeholders, as well as consistency in how and when it is measured. |
| Author | Kujawa, Tomasz Jaime Dauden, Eva-Amparo Gwyther, Holly Kurpas, Donata Bujnowska-Fedak, Maria Holland, Carol Shaw, Rachel Marcucci, Maura D’Avanzo, Barbara Cano, Antonio |
| AuthorAffiliation | 4 Family Medicine Department , Wroclaw Medical University , Wroclaw , UK 2 Department of Pediatrics, Obstetrics and Gynecology , University of Valencia , Valencia , Spain 3 Laboratory of Quality Assessment of Geriatric Therapies and Services , IRCCS – Istituto di Ricerche Farmacologiche Mario Negri , Milan , Italy 6 Faculty of Health and Medicine , Centre for Ageing Research, Furness College, Lancaster University , Lancaster , UK 5 Department of Health Research Methods, Evidence, and Impact , McMaster University , Hamilton , Canada 1 Aston Research Centre for Healthy Ageing (ARCHA), Psychology , School of Life and Health Sciences, Aston University , Birmingham , UK |
| AuthorAffiliation_xml | – name: 4 Family Medicine Department , Wroclaw Medical University , Wroclaw , UK – name: 3 Laboratory of Quality Assessment of Geriatric Therapies and Services , IRCCS – Istituto di Ricerche Farmacologiche Mario Negri , Milan , Italy – name: 1 Aston Research Centre for Healthy Ageing (ARCHA), Psychology , School of Life and Health Sciences, Aston University , Birmingham , UK – name: 5 Department of Health Research Methods, Evidence, and Impact , McMaster University , Hamilton , Canada – name: 6 Faculty of Health and Medicine , Centre for Ageing Research, Furness College, Lancaster University , Lancaster , UK – name: 2 Department of Pediatrics, Obstetrics and Gynecology , University of Valencia , Valencia , Spain |
| Author_xml | – sequence: 1 givenname: Holly surname: Gwyther fullname: Gwyther, Holly email: h.gwyther@aston.ac.uk organization: Aston Research Centre for Healthy Ageing (ARCHA), Psychology, School of Life and Health Sciences, Aston University, Birmingham, UK – sequence: 2 givenname: Rachel surname: Shaw fullname: Shaw, Rachel email: h.gwyther@aston.ac.uk organization: Aston Research Centre for Healthy Ageing (ARCHA), Psychology, School of Life and Health Sciences, Aston University, Birmingham, UK – sequence: 3 givenname: Eva-Amparo surname: Jaime Dauden fullname: Jaime Dauden, Eva-Amparo email: h.gwyther@aston.ac.uk organization: Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain – sequence: 4 givenname: Barbara surname: D’Avanzo fullname: D’Avanzo, Barbara email: h.gwyther@aston.ac.uk organization: Laboratory of Quality Assessment of Geriatric Therapies and Services, IRCCS – Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy – sequence: 5 givenname: Donata surname: Kurpas fullname: Kurpas, Donata email: h.gwyther@aston.ac.uk organization: Family Medicine Department, Wroclaw Medical University, Wroclaw, UK – sequence: 6 givenname: Maria surname: Bujnowska-Fedak fullname: Bujnowska-Fedak, Maria email: h.gwyther@aston.ac.uk organization: Family Medicine Department, Wroclaw Medical University, Wroclaw, UK – sequence: 7 givenname: Tomasz surname: Kujawa fullname: Kujawa, Tomasz email: h.gwyther@aston.ac.uk organization: Family Medicine Department, Wroclaw Medical University, Wroclaw, UK – sequence: 8 givenname: Maura surname: Marcucci fullname: Marcucci, Maura email: h.gwyther@aston.ac.uk organization: Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada – sequence: 9 givenname: Antonio surname: Cano fullname: Cano, Antonio email: h.gwyther@aston.ac.uk organization: Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain – sequence: 10 givenname: Carol surname: Holland fullname: Holland, Carol email: h.gwyther@aston.ac.uk organization: Faculty of Health and Medicine, Centre for Ageing Research, Furness College, Lancaster University, Lancaster, UK |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29331967$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.3402/qhw.v6i4.10362 10.1080/08870446.2015.1116534 10.1111/j.1532-5415.2004.52174.x 10.1016/j.archger.2016.08.009 10.1017/S1041610212000634 10.1007/s11019-006-9012-8 10.5114/fmpcr/63234 10.1093/gerona/59.3.M255 10.1016/S0140-6736(12)62167-9 10.1016/j.amjmed.2015.06.017 10.1001/jama.288.14.1775 10.1177/1468794107085301 10.1191/1478088706qp063oa 10.1016/j.ejim.2016.03.005 10.1186/1741-7015-11-65 10.1111/j.1532-5415.2006.00745.x 10.1177/1525822X05279903 10.1093/intqhc/mzm042 10.1093/gerona/56.3.M146 10.12927/hcpol.2016.24522 10.1159/000115340 10.1093/gerona/62.7.738 10.1056/NEJMoa020423 10.1007/s11357-013-9586-z 10.1017/S0144686X17000745 10.1016/j.cger.2010.08.008 10.1017/S0266462307080014 10.1377/hlthaff.28.1.75 10.1038/sj.ejcn.1602168 10.1371/journal.pone.0180127 10.1093/gerona/gls119 10.1016/j.jamda.2016.04.018 10.1111/j.1532-5415.2009.02480.x 10.4061/2011/569194 10.3402/qhw.v10.27370 10.1016/0749-5978(91)90020-T 10.1186/s12875-014-0212-7 |
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| References | Shaw, Gwyther, Holland 2017; 128 Galvin, Todres 2011; 6 Langlois, Vu, Kergoat 2012; 24 Apóstolo, Cooke, Bobrowicz-Campos 2017 Luger, Dorner, Haider 2016; 17 Bowen 2008; 8 Guest, Bunce, Johnson 2006; 18 Cano, Kurpas, Bujnowska-Fedak 2016; 3 Coleman, Austin, Brach 2009; 28 Bodenheimer, Wagner, Grumbach 2002; 288 Cesari, Marzetti, Thiem 2016; 31 Gill, Baker, Gottschalk 2002; 347 Rockwood, Mitnitski 2011; 27 Topinková 2008; 52 Shaw, Pattison, Holland 2015; 16 Elshaug, Hiller, Moss 2008; 24 Ferrucci, Guralnik, Studenski 2004; 52 Walston, Hadley, Ferrucci 2006; 54 Braun, Clarke 2006; 3 Koelen, Lindström 2005; 59 Borg Xuereb, Shaw, Lane 2016; 31 Wagner, Davis, Schaefer 1999; 7 Fried, Ferrucci, Darer 2004; 59 Theou, Stathokostas, Roland 2011; 2011 Tong, Sainsbury, Craig 2007; 19 D’Avanzo, Shaw, Riva 2017; 12 Cameron, Fairhall, Langron 2013; 11 Clavel, De Coster, Pomey 2016; 11 Jette, Grover, Keck 2003; 83 Cherniack, Florez, Troen 2007; 12 Cadore, Casas-Herrero, Zambom-Ferraresi 2014; 36 Rockwood, Andrew, Mitnitski 2007; 62 Fried, Tangen, Walston 2001; 56 Ng, Feng, Nyunt 2015; 128 Clegg, Young, Iliffe 2013; 381 Andreasen, Lund, Aadahl 2015; 10 Rodríguez-Mañas, Féart, Mann 2013; 68 Todres, Galvin, Dahlberg 2007; 10 Kapan, Luger, Haider 2017; 68 Ajzen 1991; 50 Lang, Hubbard, Andrew 2009; 57 29523577 - BMJ Open. 2018 Mar 8;8(3):e018653corr1 |
| References_xml | – volume: 6 start-page: 10362 year: 2011 article-title: Kinds of well-being: A conceptual framework that provides direction for caring publication-title: Int J Qual Stud Health Well-being doi: 10.3402/qhw.v6i4.10362 – volume: 12 start-page: 246 year: 2007 article-title: Emerging therapies to treat frailty syndrome in the elderly publication-title: Altern Med Rev – volume: 31 start-page: 436 year: 2016 article-title: Patients’ and physicians’ experiences of atrial fibrillation consultations and anticoagulation decision-making: A multi-perspective IPA design publication-title: Psychol Health doi: 10.1080/08870446.2015.1116534 – volume: 83 start-page: 224 year: 2003 article-title: A qualitative study of clinical decision making in recommending discharge placement from the acute care setting publication-title: Phys Ther – volume: 52 start-page: 625 year: 2004 article-title: Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: a consensus report publication-title: J Am Geriatr Soc doi: 10.1111/j.1532-5415.2004.52174.x – volume: 68 start-page: 25 year: 2017 article-title: Fear of falling reduced by a lay led home-based program in frail community-dwelling older adults: A randomised controlled trial publication-title: Arch Gerontol Geriatr doi: 10.1016/j.archger.2016.08.009 – volume: 24 start-page: 1429 year: 2012 article-title: The multiple dimensions of frailty: physical capacity, cognition, and quality of life publication-title: Int Psychogeriatr doi: 10.1017/S1041610212000634 – volume: 10 start-page: 53 year: 2007 article-title: Lifeworld-led healthcare: revisiting a humanising philosophy that integrates emerging trends publication-title: Med Health Care Philos doi: 10.1007/s11019-006-9012-8 – volume: 3 start-page: 373 year: 2016 article-title: FOCUS: Frailty Management Optimisation through EIPAHA Commitments and Utilisation of Stakeholders’ Input – an innovative European Project in elderly care* publication-title: Fam Med Prim Care Rev doi: 10.5114/fmpcr/63234 – volume: 59 start-page: M255 year: 2004 article-title: Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care publication-title: J Gerontol A Biol Sci Med Sci doi: 10.1093/gerona/59.3.M255 – year: 2017 article-title: Systematic review of effectiveness of frailty interventions with recommendations publication-title: JBI Database System Rev Implement Rep – volume: 381 start-page: 752 year: 2013 article-title: Frailty in elderly people publication-title: Lancet doi: 10.1016/S0140-6736(12)62167-9 – volume: 128 start-page: 1225 year: 2015 article-title: Nutritional, Physical, Cognitive, and Combination Interventions and Frailty Reversal Among Older Adults: A Randomized Controlled Trial publication-title: Am J Med doi: 10.1016/j.amjmed.2015.06.017 – volume: 288 start-page: 1775 year: 2002 article-title: Improving primary care for patients with chronic illness publication-title: JAMA doi: 10.1001/jama.288.14.1775 – volume: 8 start-page: 137 year: 2008 article-title: Naturalistic inquiry and the saturation concept: a research note publication-title: Qual Res doi: 10.1177/1468794107085301 – volume: 3 start-page: 77 year: 2006 article-title: Using thematic analysis in psychology publication-title: Qual Res Psychol doi: 10.1191/1478088706qp063oa – volume: 31 start-page: 11 year: 2016 article-title: The geriatric management of frailty as paradigm of “The end of the disease era” publication-title: Eur J Intern Med doi: 10.1016/j.ejim.2016.03.005 – volume: 11 start-page: 1 year: 2013 article-title: A multifactorial interdisciplinary intervention reduces frailty in older people: randomized trial publication-title: BMC Med doi: 10.1186/1741-7015-11-65 – volume: 54 start-page: 991 year: 2006 article-title: Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults publication-title: J Am Geriatr Soc doi: 10.1111/j.1532-5415.2006.00745.x – volume: 18 start-page: 59 year: 2006 article-title: How Many Interviews Are Enough? publication-title: Field methods doi: 10.1177/1525822X05279903 – volume: 19 start-page: 349 year: 2007 article-title: Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups publication-title: Int J Qual Health Care doi: 10.1093/intqhc/mzm042 – volume: 56 start-page: M146 year: 2001 article-title: Frailty in older adults: evidence for a phenotype publication-title: J Gerontol A Biol Sci Med Sci doi: 10.1093/gerona/56.3.M146 – volume: 11 start-page: 80 year: 2016 article-title: Appropriateness for Total Joint Replacement: Perspectives of Decision-Makers publication-title: Healthc Policy doi: 10.12927/hcpol.2016.24522 – volume: 52 start-page: 6 year: 2008 article-title: Aging, disability and frailty publication-title: Ann Nutr Metab doi: 10.1159/000115340 – volume: 62 start-page: 738 year: 2007 article-title: A comparison of two approaches to measuring frailty in elderly people publication-title: J Gerontol A Biol Sci Med Sci doi: 10.1093/gerona/62.7.738 – volume: 347 start-page: 1068 year: 2002 article-title: A program to prevent functional decline in physically frail, elderly persons who live at home publication-title: N Engl J Med doi: 10.1056/NEJMoa020423 – volume: 36 start-page: 773 year: 2014 article-title: Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians publication-title: Age doi: 10.1007/s11357-013-9586-z – volume: 128 start-page: 1 year: 2017 article-title: Understanding frailty: meanings and beliefs about screening and prevention across key stakeholder groups in Europe publication-title: Ageing Soc doi: 10.1017/S0144686X17000745 – volume: 7 start-page: 56 year: 1999 article-title: A survey of leading chronic disease management programs: are they consistent with the literature? publication-title: Manag Care Q – volume: 27 start-page: 17 year: 2011 article-title: Frailty defined by deficit accumulation and geriatric medicine defined by frailty publication-title: Clin Geriatr Med doi: 10.1016/j.cger.2010.08.008 – volume: 24 start-page: 1 year: 2008 article-title: Exploring policy-makers’ perspectives on disinvestment from ineffective healthcare practices publication-title: Int J Technol Assess Health Care doi: 10.1017/S0266462307080014 – volume: 28 start-page: 75 year: 2009 article-title: Evidence On The Chronic Care Model In The New Millennium publication-title: Health Aff doi: 10.1377/hlthaff.28.1.75 – volume: 59 start-page: S10 year: 2005 article-title: Making healthy choices easy choices: the role of empowerment publication-title: Eur J Clin Nutr doi: 10.1038/sj.ejcn.1602168 – volume: 12 year: 2017 article-title: Stakeholders’ views and experiences of care and interventions for addressing frailty and pre-frailty: a meta-synthesis of qualitative evidence publication-title: PLoS One doi: 10.1371/journal.pone.0180127 – volume: 68 start-page: 62 year: 2013 article-title: Searching for an operational definition of frailty: a Delphi method based consensus statement: the frailty operative definition-consensus conference project publication-title: J Gerontol A Biol Sci Med Sci doi: 10.1093/gerona/gls119 – volume: 17 start-page: 671.e9 year: 2016 article-title: Effects of a home-based and volunteer-administered physical training, nutritional, and social support program on malnutrition and frailty in older persons: a randomized controlled trial publication-title: J Am Med Dir Assoc doi: 10.1016/j.jamda.2016.04.018 – volume: 57 start-page: 1776 year: 2009 article-title: Neighborhood deprivation, individual socioeconomic status, and frailty in older adults publication-title: J Am Geriatr Soc doi: 10.1111/j.1532-5415.2009.02480.x – volume: 2011 start-page: 1 year: 2011 article-title: The effectiveness of exercise interventions for the management of frailty: a systematic review publication-title: J Aging Res doi: 10.4061/2011/569194 – volume: 10 start-page: 27370 year: 2015 article-title: The experience of daily life of acutely admitted frail elderly patients one week after discharge from the hospital publication-title: Int J Qual Stud Health Well-being doi: 10.3402/qhw.v10.27370 – volume: 50 start-page: 179 year: 1991 article-title: The theory of planned behavior publication-title: Organ Behav Hum Decis Process doi: 10.1016/0749-5978(91)90020-T – volume: 16 start-page: 1 year: 2015 article-title: Be SMART: examining the experience of implementing the NHS Health Check in UK primary care publication-title: BMC Fam Pract doi: 10.1186/s12875-014-0212-7 – reference: 29523577 - BMJ Open. 2018 Mar 8;8(3):e018653corr1 |
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| Snippet | ObjectiveTo elicit European healthcare policy-makers’ views, understanding and attitudes about the implementation of frailty screening and management... To elicit European healthcare policy-makers' views, understanding and attitudes about the implementation of frailty screening and management strategies and... |
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| SubjectTerms | Administrative Personnel Aged Aged, 80 and over Attitude of Health Personnel Chronic illnesses Clinical decision making Decision Making Delivery of Health Care - methods Europe European Union Frail Elderly Frailty Frailty - diagnosis Frailty - therapy Geriatric Medicine Health Knowledge, Attitudes, Practice Health Policy Health Resources Humans Organizational Culture Patient-centered care Policy Making Prevention Qualitative Research Social Environment Well being |
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| Title | Understanding frailty: a qualitative study of European healthcare policy-makers’ approaches to frailty screening and management |
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