225 The pattern of ICPOP service use according to the clinical frailty scale

Abstract

Abstract Background We are a specialist integrated team working with older people to co-ordinate and provide enhanced health and social care services through Comprehensive Geriatric Assessment (CGA) and intervention working across a large geographical region. Methods New patients who underwent CGA from January–May 2023 were suitable for inclusion in this retrospective study. Key parameters including demographics, cognitive and functional status were recorded and analysed according to the following categories of clinical frailty scale (CFS); 1–3 (non-frail), 4–6 (frail) and ≥ 7 (severely frail). Results Of 249 patients who underwent CGA, 64% (n = 159) were female with a mean age of 82, and median MOCA score of 17. Reasons for referral were new or unexpected change in cognition (52%) frailty (40%) and falls (37%). Among this cohort 20% (n = 51) were non-frail, 71% (n = 177) were frail and 8.4% (n = 21) were severely frail. There was no significant difference in mean MOCA score by level of frailty (p = 0.49). Impairment in Instrumental Activities of Daily Living (IADL) was identified in 26% of non-frail, 77% of frail and 100% of severely frail patients. 27% of non-frail, 43% of frail and 33% of severely frail patients were living alone with carer strain reported in 70% of those with severe frailty. Informal care was regularly provided to 35% of non-frail, 60% of frail and 90% of severely frail patients. Conclusion Patients attending our service are frail, older and predominantly female. We identified a cohort who are not classified as frail but have cognitive impairment, are dependent for support in IADLs and reliant on informal care to allow them to live independently. In addition, we are supporting a severely frail, heavily dependent cohort and their caregivers. This demonstrates the complex case load within our ICPOP service which requires ongoing evaluation to ensure delivery of high quality person-centred interventions.