Implementation of frailty screening for older people living with HIV in Brighton, UK

• Published in: HIV medicine Vol. 25; no. 4; pp. 484 - 490
• Main Authors: Clair‐Sullivan, Natalie St, Bristowe, Katherine, Khan, Inayat, Maddocks, Matthew, Harding, Richard, Bremner, Stephen, Levett, Thomas, Roberts, Jonathan, Adler, Zoe, Yi, Deokhee, Vera, Jaime H.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.04.2024
• Subjects: Aged; ageing; Comorbidity; Frail Elderly; Frailty; Frailty - diagnosis; Frailty - epidemiology; Geriatric Assessment; Geriatrics; HIV; HIV Infections - complications; HIV Infections - diagnosis; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Middle Aged; Older people; Robustness; screening; United Kingdom - epidemiology; United Kingdom; United Kingdom > UK; frailty; geriatrics; ageing; screening; HIV
• ISSN: 1464-2662; 1468-1293
• DOI: 10.1111/hiv.13598

Objectives To evaluate the implementation of frailty screening in people living with HIV (PLWH) in a large urban cohort of patients in Brighton, UK. Methods Focus group discussions with HIV professionals and PLWH interviews helped inform the design and implementation of the frailty screening pathway in the clinic. Data were collected from PLWH aged over 60 years attending their HIV annual health check from July 2021 to January 2023 (n = 590), who were screened for frailty by nurses using the FRAIL scale. We assessed the proportions of PLWH who screened as frail, prefrail or robust and compared patient characteristics across groups. All PLWH identified as frail were offered a comprehensive geriatric assessment delivered by a combined HIV geriatric clinic, and uptake was recorded. Results A total of 456/590 (77.3%) PLWH aged over 60 years were screened for frailty. Median age and time since HIV diagnosis (range) for those screened were 66 (60–99) years and 21 (0–32) years, respectively. In total, 56 (12.1%) of those screened were identified as frail, 118 (25.9%) as prefrail and 282 (61.8%) as robust. A total of 10/56 (18%) people identified as frail declined an appointment in the geriatric clinic. Compared with non‐frail individuals, frail PLWH had been living with HIV for longer and had a greater number of comorbidities and comedications but were not chronologically older. Conclusions Implementing frailty screening in PLWH over 60 years old is feasible in a large cohort of PLWH, as recommended by the European AIDS Clinical Society. More research is needed to determine if frailty screening can improve clinical outcomes of older PLWH and the use of the comprehensive geriatric assessment within HIV services.