Patient-outcomes of a frailty management program for community-dwelling older adults in Singapore: A cohort evaluation
Year: 2025
Type: article
Study design: Clinical Trial
Abstract: Background There is urgency to manage frailty due to its increasing prevalence. The Geriatric Service Hub (GSH) is a novel programme in Singapore, which aims to manage frailty amongst community-dwelling older adults. Objectives We aimed to (1) assess the effectiveness of the GSH through patient-outcomes including patient activation, functional status, and quality-of-life (QoL), and (2) assess impact on patient-outcomes through different levels of frailty using the Clinical Frailty Scale (CFS) scores. Design Single-arm pre-post design. Setting Community-based health and social care provider Participants 218 GSH patients, aged≥65, with CFS4 to CFS7. Intervention Patients received comprehensive geriatric assessments in community-based settings and had individualised care plans formed by a multi-disciplinary care team. Patients were then referred to health and social services located in the community based on identified needs. Measurements Functional status (Barthel Index), Patient activation (Patient Activation Measure), health-related QoL (EuroQoL 5-dimension 5-level tool) and the emotional-related QoL (Control, Autonomy, Self-realisation, and Pleasure tool). Measurements administered at baseline, 3- and 6-months post-enrolment. Analysis included unadjusted t -tests and multi-level mixed-effects linear regression. Results We studied 191 (87.6 %) participants who completed all 3-timepoints. Compared to baseline, functional status was maintained at 3-months (M diff =-0.2, 95 % CI [-1.8;1.3]) and 6-months (M diff =-0.5, 95 % CI[-2.2;1.2]). Patient activation increased slightly at 3-months (M diff =3.0, 95 % CI [0.1;5.9]) but not at 6-months (M diff =1.5, 95 % CI [-1.2;4.1]). There were significant increases for health-related QoL a t 3-months (M diff =0.068, 95 %CI [0.041;0.095]) and 6-months (M diff =0.045, 95 % CI [0.016;0.074]), and for emotional-related QoL at 3-months (M diff =2.3, 95 % CI [1.2;3.3]) and 6-months (M diff =1.5, 95 % CI [0.4;2.7]). For sub-group analyses, there were significant increases for patient activation and both QoL measurements for patients categorised as CFS4 and CFS5, and no significant changes for patient-outcomes for CFS6–7. Conclusions Overall, results suggest maintenance in patient activation and functional status, with improvements in QoL. Sub-group analyses suggest that GSH is beneficial for patients categorised as CFS4 and CFS5, but the programme played a largely maintenance role for patients with CFS6–7.
Source: The Journal of Frailty & Aging
Authors: Ze Ling Nai, Robin Choo, Grace Sum, Siew Fong Goh, Yew Yoong Ding, Wee Shiong Lim, Woan Shin Tan, Robyn Hwee Teng Tan, June Poh Hoon Teng, Edward Tzu Kwang Tan, Chui Rhong Chang, Santhosh Kumar Seetharaman, Christopher Tsung Chien Lien, Barbara Helen Rosario, Shou Lin Low, Arron Seng Hock Ang, Karen Lai Ming Kan, Milawaty Nurjono, Lian Leng Low, Esther Li Ping Lim, Laura Bee Gek Tay, Melvin Peng Wei Chua, Yee Sien Ng
Language: English
Topic: Frailty in Older Adults
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,850
Funder: Ministry of Health -Singapore
OpenAlex ID: W4410427667