Older people's perspectives on frailty screening in primary care settings - a citizens' jury study.

Background: As the world's population ages, there is a growing concern with frailty, marked by reduced strength and greater vulnerability to stress. Overcoming obstacles like reluctance towards screening methods in this process is crucial for identifying and addressing frailty at an early stage. Understanding older people's perspectives can help adapt screening procedures in primary healthcare settings.

Hypertension among people living with human immunodeficiency virus in sub-Saharan Africa: a systematic review and meta-analysis.

We performed a systematic review and meta-analysis of hypertension in people living with human immunodeficiency virus (HIV) in sub-Saharan Africa (SSA). We searched the PubMed, Google Scholar, African Index Medicus, and Embase databases to identify studies published from January 1, 2010, to December 31, 2021. We used a random-effects model to estimate the pooled prevalence of hypertension and mean SBP/DBP level on a sex-specific basis.

Projected burden and distribution of elevated blood pressure levels and its consequence among adolescents in sub-Saharan Africa.

Background: There is minimal data on the number of adolescents in sub-Saharan Africa (SSA) with elevated blood pressure (BP) at increased risk of future cardiovascular events. Combining country-specific population data with data derived from two previously conducted meta-analyses (one African-specific, one based on international cohorts), we sought to address this knowledge deficit.

Methods: We used meta-analysis data from 37 926 adolescents participating in 36 contemporary SSA studies to generate sex-specific proportions of adolescents aged 10-14 and 15-19 years with elevated BP.

Community views on the secondary use of general practice data: Findings from a mixed-methods study.

Introduction: General practice data, particularly when combined with hospital and other health service data through data linkage, are increasingly being used for quality assurance, evaluation, health service planning and research. In this study, we explored community views on sharing general practice data for secondary purposes, including research, to establish what concerns and conditions need to be addressed in the process of developing a social licence to support such use.

Methods: We used a mixed-methods approach with focus groups (November-December 2021), followed by a cross-sectional survey (March-April 2022).

Elevated blood pressure among adolescents in sub-Saharan Africa: a systematic review and meta-analysis.

Background: More people from sub-Saharan Africa aged between 20 years and 60 years are affected by end-organ damage due to underlying hypertension than people in high-income countries. However, there is a paucity of data on the pattern of elevated blood pressure among adolescents aged 10-19 years in sub-Saharan Africa. We aimed to provide pooled estimates of high blood pressure prevalence and mean levels in adolescents aged 10-19 years across sub-Saharan Africa.

V-CarE-A Conceptual Design Model for Providing COVID-19 Pandemic Awareness: Proposal for a Virtual Reality Design Approach to Facilitate People With Persistent Postural-Perceptual Dizziness.

Background: Virtual reality (VR) technology has been solidifying its ground since its existence, where engagement and a sense of presence are key. The contemporary field of development has captured the attention of researchers due to its flexibility and compatibility attributes. During the COVID-19 pandemic, several research outputs have shown promising prospects of continuing research in the field of VR design and development-in health sciences including learning and training.

Does CGA Improve Health Outcomes in the Community? An Umbrella Review.

Objectives: To perform an umbrella review of systematic reviews with meta-analyses (MAs) examining the effectiveness of comprehensive geriatric assessment (CGA) delivered within community settings to general populations of community-dwelling older people against various health outcomes.

Design: Umbrella review of MAs of randomized controlled trials (RCTs).

Setting And Participants: Systematic reviews with MAs examining associations between CGA conducted within the community and any health outcome, where participants were community-dwelling older people with a minimum mean age of 60 years or where at least 50% of study participants were aged ≥60 years.

Evolving Hybrid Partial Genetic Algorithm Classification Model for Cost-effective Frailty Screening: Investigative Study.

Background: A commonly used method for measuring frailty is the accumulation of deficits expressed as a frailty index (FI). FIs can be readily adapted to many databases, as the parameters to use are not prescribed but rather reflect a subset of extracted features (variables). Unfortunately, the structure of many databases does not permit the direct extraction of a suitable subset, requiring additional effort to determine and verify the value of features for each record and thus significantly increasing cost.

Practitioner perceptions of the feasibility of common frailty screening instruments within general practice settings: a mixed methods study.

Background: Frailty is a highly prevalent clinical syndrome increasing older people's vulnerability to risk of adverse outcomes. Better frailty identification through expanded screening implementation has been advocated within general practice settings, both internationally and within Australia. However, little is known about practitioner perceptions of the feasibility of specific instruments, and the underlying motivations behind those perceptions.

Out with the Old and In with the New: Primary Care Management of Heart Failure with Preserved Ejection Fraction.

Primary care plays an integral role in the management of complex, chronic disease states such as heart failure. However, there is a disconnect between the characteristics of those recruited into clinical trials and those managed in the real world, which means the contribution and consideration of primary care in current guidelines is suboptimal. In this article, the authors explore key issues in the diagnosis and management of heart failure that need to be addressed from a primary care perspective.

Variation in Seeking Care for Cardiovascular Disease and Ambulance Utilization among Migrants in Australia: Time, Ethnicity, and Delay (TED) Study III.

Insight into differences in seeking medical care for chest pain among migrant populations is limited. This study aimed to determine ethnic differences in seeking care behaviors and using ambulances among migrants compared to an Australian-born group. A total of 607 patients presenting with chest pain to a tertiary hospital between 1 July 2012 and 30 June 2014 were randomly selected.

Utilisation of general practice health assessments around an aged care assessment is associated with lower mortality risk in older Australians.

Objective: (i) to describe the general practitioner utilisation of health assessments, management plans, coordination of team care arrangements and medication review item numbers within 6 months of an aged care eligibility assessment for home care packages (HCP) and (ii) investigate the impact of health assessments on the risk of mortality and entry into permanent residential aged care (PRAC) of individuals accessing HCP.

Design And Setting: retrospective cohort study utilising data from the Registry of Senior Australians (ROSA) was conducted.

Subjects: 75,172 individuals aged ≥75 years who received HCP between 2011 and 2015.

Feasibility and acceptability of commonly used screening instruments to identify frailty among community-dwelling older people: a mixed methods study.

Background: Frailty exposes older people to an elevated risk of a range of negative outcomes. Emerging evidence that frailty can be effectively treated within community settings has stimulated calls for more proactive screening within primary care. Assessing feasibility is a critical preliminary step in assessing the efficacy of interventions such as screening.

Commonly Used Screening Instruments to Identify Frailty Among Community-Dwelling Older People in a General Practice (Primary Care) Setting: A Study of Diagnostic Test Accuracy.

Background: Rapid frailty screening remains problematic in primary care. The diagnostic test accuracy (DTA) of several screening instruments has not been sufficiently established. We evaluated the DTA of several screening instruments against two reference standards: Fried's Frailty Phenotype [FP] and the Adelaide Frailty Index [AFI]), a self-reported questionnaire.

Structuring a conceptual model for cost-effectiveness analysis of frailty interventions.

Background: Frailty is a major health issue which impacts the life of older people, posing a significant challenge to the health system. One of the key emerging areas is the development of frailty interventions to halt or reverse the progression of the condition. In many countries, economic evidence is required to inform public funding decisions for such interventions, and cost-effectiveness models are needed to estimate long-term costs and effects.

General practitioners' perceptions, attitudes and experiences of frailty and frailty screening.

Background And Objectives: General practitioners (GPs) are uniquely positioned to support frailty identification and management. However, awareness of frailty and its treatment remains an emergent concept for many. Consequently, our aim was to explore GPs' perceptions, attitudes and experiences of frailty and frailty screening.

Should we screen for frailty in primary care settings? A fresh perspective on the frailty evidence base: A narrative review.

With older adults living longer, health service providers have increasingly turned their attention towards frailty and its significant consequences for health and well-being. Consequently, frailty screening has gained momentum as a possible health policy answer to the question of what can be done to prevent frailty's onset and progression. However, who should be screened for frailty, where and when remains a subject of extensive debate.

Application of an electronic Frailty Index in Australian primary care: data quality and feasibility assessment.

Background: The primary care setting is the ideal location for identifying the condition of frailty in older adults.

Aims: The aim of this pragmatic study was twofold: (1) to identify data items to extract the data required for an electronic Frailty Index (eFI) from electronic health records (EHRs); and (2) test the ability of an eFI to accurately and feasibly identify frailty in older adults.

Methods: In a rural South Australian primary care clinic, we derived an eFI from routinely collected EHRs using methodology described by Clegg et al.

Workforce innovation: Embracing emerging technologies.

Background: In a rapidly evolving digital world, it is crucial that general practice embraces the potential of artificial intelligence (AI) and virtual reality (VR) in a real and proactive manner.

Objective: Using examples of AI and VR, the article outlines some of the benefits and challenges we face in integrating these digital tools into daily clinical practice and our training programs.

Discussion: It is clear that AI and VR digital innovations will continue to grow in significance, with more and more options being offered to clinicians.

Feasibility, acceptability and diagnostic test accuracy of frailty screening instruments in community-dwelling older people within the Australian general practice setting: a study protocol for a cross-sectional study.

Introduction: Frailty is one of the most challenging aspects of population ageing due to its association with increased risk of poor health outcomes and quality of life. General practice provides an ideal setting for the prevention and management of frailty via the implementation of preventive measures such as early identification through screening.

Methods And Analysis: Our study will evaluate the feasibility, acceptability and diagnostic test accuracy of several screening instruments in diagnosing frailty among community-dwelling Australians aged 75+ years who have recently made an appointment to see their general practitioner (GP).

Perspectives of Frailty and Frailty Screening: Protocol for a Collaborative Knowledge Translation Approach and Qualitative Study of Stakeholder Understandings and Experiences.

Background: Accompanying the unprecedented growth in the older adult population worldwide is an increase in the prevalence of frailty, an age-related clinical state of increased vulnerability to stressor events. This increased vulnerability results in lower social engagement and quality of life, increased dependency, and higher rates of morbidity, health service utilization and mortality. Early identification of frailty is necessary to guide implementation of interventions to prevent associated functional decline.

Unconnected and out-of-sight: identifying health care non-users with unmet needs.

Background: While current debates on how to deliver sustainable health care recognise socio-economic dimensions to health service use, attention has focussed on how to reduce demand for services. However, the measures of demand may not account for a subgroup of the population who to date have remained out of sight because they do not access health services. This study aimed to describe the characteristics of individuals who self-reported having fair or poor health but did not use health services.