title: Best practice guidelines for the management of frailty: a British Geriatrics Society, Age UK and Royal College of General Practitioners report.
abstract: Older people are majority users of health and social care services in the UK and internationally. Many older people who access these services have frailty, which is a state of vulnerability to adverse outcomes. The existing health care response to frailty is mainly secondary care-based and reactive to the acute health crises of falls, delirium and immobility. A more proactive, integrated, person-centred and community-based response to frailty is required. The British Geriatrics Society Fit for Frailty guideline is consensus best practice guidance for the management of frailty in community and outpatient settings.
  The BGS recommends that all encounters between health and social care staff and older people in community and outpatient settings should include an assessment for frailty. A gait speed <0.8m/s; a timed-up-and-go test >10s; and a score of ≥3 on the PRISMA 7 questionnaire can indicate frailty. The common clinical presentations of frailty (falls, delirium, sudden immobility) can also be used to indicate the possible presence of frailty.
  The BGS recommends an holistic medical review based on the principles of comprehensive geriatric assessment (CGA) for all older people identified with frailty. This will: diagnose medical illnesses to optimise treatment; apply evidence-based medication review checklists (e.g. STOPP/START criteria); include discussion with older people and carers to define the impact of illness; work with the older person to create an individualised care and support plan.
  The BGS does not recommend population screening for frailty using currently available instruments.
authors.affiliation: Southern Health NHS Foundation Trust , Lymington hospital, Wellworthy Road, Lymington SO41 8QD, UK.
authors.forename: Gill
authors.initials: G
authors.lastname: Turner
authors.affiliation: Academic Unit of Elderly Care & Rehabilitation, University of Leeds, Temple Bank House, Bradford Teaching Hospitals NHS Foundation Trust, West Yorkshire, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Clegg
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000553:Ambulatory Care / Q000592:standards; D019985:Benchmarking / Q000592:standards*; D057189:Checklist / Q000592:standards; D032921:Consensus; D019033:Delivery of Health Care, Integrated / Q000592:standards; D019468:Disease Management; D005080:Exercise Test / Q000592:standards; D016330:Frail Elderly; D015577:Geriatric Assessment; D005853:Geriatrics / Q000592:standards*; D006299:Health Services for the Aged / Q000592:standards*; D006801:Humans; D018802:Patient-Centered Care / Q000592:standards; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires / Q000592:standards
keywords: best practice guidelines; frailty; older people