PRIMARY CARE FOR FRAIL OLDER ADULTS AT THE END OF LIFE: CAN A FRAILTY INDEX ENHANCE ROUTINE CARE? Open Access

Recognising that a patient is nearing the end of life allows physicians to discuss prognosis and preferences for end of life care. Finding the right time to introduce palliative and terminal care for frail older patients can be a challenge. This study aims to determine whether an electronic frailty index (eFI) constructed from health care records can be used to identify palliative care needs in older patients nearing the end of life. Data from electronic health of 30,000 patients were analysed (15,000 patients age >75 who died between 2014 and 2015 matched by age and sex to 15,000 patients with no record of death). Monthly changes in frailty (eFI) over a one year period prior to death, key symptoms and diagnoses, medication, service utilization and mortality will be described. Latent growth models will be used to identify subgroups of patients where a defined change in frailty score predicts a need for palliative care. This study will illustrate the potential of automatically generated scores in electronic health records to inform end of life care for frail older adults.