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HIV Medicine - 2023 - Clair%E2%80%90Sullivan - Implementation of frailty screening for older people living with HIV in Brighton UK.pdf (696.77 kB)

Implementation of frailty screening for older people living with HIV in Brighton, UK

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posted on 2024-01-03, 09:28 authored by Natalie S Clair-Sullivan, Katherine Bristowe, Inayat Khan, Matthew Maddocks, Richard Harding, Stephen BremnerStephen Bremner, Thomas LevettThomas Levett, Jonathan Roberts, Zoe Adler, Deokhee Yi, Jaime Vera RojasJaime Vera Rojas

Objectives:

To evaluate the implementation of frailty screening in people living with HIV (PLWH) in a large urban cohort of patients in Brighton, UK.

Methods:

Focus group discussions with HIV professionals and PLWH interviews helped inform the design and implementation of the frailty screening pathway in the clinic. Data were collected from PLWH aged over 60 years attending their HIV annual health check from July 2021 to January 2023 (n = 590), who were screened for frailty by nurses using the FRAIL scale. We assessed the proportions of PLWH who screened as frail, prefrail or robust and compared patient characteristics across groups. All PLWH identified as frail were offered a comprehensive geriatric assessment delivered by a combined HIV geriatric clinic, and uptake was recorded.

Results:

A total of 456/590 (77.3%) PLWH aged over 60 years were screened for frailty. Median age and time since HIV diagnosis (range) for those screened were 66 (60–99) years and 21 (0–32) years, respectively. In total, 56 (12.1%) of those screened were identified as frail, 118 (25.9%) as prefrail and 282 (61.8%) as robust. A total of 10/56 (18%) people identified as frail declined an appointment in the geriatric clinic. Compared with non-frail individuals, frail PLWH had been living with HIV for longer and had a greater number of comorbidities and comedications but were not chronologically older.

Conclusions:

Implementing frailty screening in PLWH over 60 years old is feasible in a large cohort of PLWH, as recommended by the European AIDS Clinical Society. More research is needed to determine if frailty screening can improve clinical outcomes of older PLWH and the use of the comprehensive geriatric assessment within HIV services.

History

Publication status

  • Published

File Version

  • Published version

Journal

HIV Medicine

ISSN

1464-2662

Publisher

Wiley

Department affiliated with

  • Primary Care and Public Health Publications
  • Global Health and Infection Publications
  • BSMS Publications
  • Division of Medical Education Publications

Institution

University of Sussex

Full text available

  • Yes

Peer reviewed?

  • Yes