Frailty and sarcopenia among older people with upper limb fractures Musculoskeletal Diseases
Conditions
Interventions
Patients attending fracture clinic will be assessed for frailty and sarcopenia in addition to the usual care (which involves fracture review, determining patients’ risk of future fracture and consider
consideration of unmet needs in physical, cognitive, and social domains
and referrals to other clinical, social care or voluntary services. These actions and referrals will be varied and focussed on the individual patient’s recognised needs and their wishes.
Sponsors
University Hospital Southampton NHS Foundation Trust
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Aged 65 + years 2. Single arm fracture (wrist or upper arm) 3. Referred directly from A&E, GP, local minor injuries unit or other fracture clinics 4. Able to give informed consent and not previously diagnosed with frailty and/or sarcopenia
Exclusion criteria
Exclusion criteria: 1. Pathological fractures 2. Multiple or lower limb fractures 3. Active cancer diagnosis 4. Care home residents
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Feasibility of assessing frailty and sarcopenia among patients with upper limb fracture: This will be determined by: a) the percentage of people that are assessed by each tool (adequacy) b) availability of required data and the number of missing data c) equipment (including cost, availability of functioning equipment and frequency of calibration) d) the time for carrying out each assessment e) acceptability of the tools by staff and patients (via interviews). This will determine the prevalence of frailty and sarcopenia among the study participants and which measures of assessing frailty and sarcopenia are most feasible in this population 2. Feasibility of using existing care pathways: Patients identified as having either frailty or sarcopenia will be referred to local geriatric clinical services for specialist review as outlined in the intervention. The actions instigated from these assessments and referrals will be varied and individualised according to patient’s needs and wishes. These referrals may lead to additional attendance at out-patients, primary care or exercise classes for example. We will report the number of patients identified to have frailty and/or sarcopenia who are referred to CGA, the number of those who receive CGA, and the number and type of follow up interventions. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Falls and fractures: participants will be asked to fill in a falls diary recording the date, suspected cause, location and the consequences of each fall. They will be contacted by telephone at 3 and 6 months after recruitment to collect self-assessed information on falls and fractures within the previous 3 months. This will establish whether quarterly data collection is suitable for the future trial. 2. Mortality: death rates within 6 months of recruitment will be collected from the hospital patient administration system (PAS) 3. Future outcome measures: Baseline data on nutritional, physical and cognitive factors which may be associated with frailty and sarcopenia status will be collected. Quality of life and physical function will be measured at baseline, and 3 months and 6 months after recruitment. The feasibility of using each of these assessments in this patient group will inform which instrument will be used in the future trial. 4. Costs and healthcare resource use: We will capture the number, type and resource implications of these referrals during the 6 months post recruitment via quarterly phone calls with participants. We will also abstract data on healthcare resource use from the hospital patient administration system (PAS) and primary care electronic records. | — |
Countries
England, United Kingdom
Outcome results
None listed