HHS researcher Courtney Kennedy, PhD, led the development of the Fit-Frailty app to help health care providers make decisions and plan care for frail patients.
A new app developed in Hamilton is helping researchers and health professionals measure frailty and function in older people.
Frailty is a medical condition that involves a decline in function and health. Frailty reduces the body's ability to recover from illness. Lack of exercise, poor nutrition, social isolation and taking multiple medications can lead to frailty.
Dr. Courtney Kennedy, a Hamilton Health Sciences (HHS) research scientist and occupational therapist with a PhD in clinical epidemiology, co-led the development of the Fit-Frailty app to help healthcare professionals make decisions and plan care for frail patients. Dr. Kennedy also serves as coordinator for the HHS Hospital 2 Home program, which provides care to patients who suffer from multiple chronic conditions and face social and economic barriers to staying healthy.
“We are now rolling out the Fit-Frailty app to hospital patients to further test its usefulness.” — Dr. Courtney Kennedy
This easy-to-use tool helps healthcare professionals identify risk of frailty and age-related loss of muscle mass and strength through an in-person assessment in under 15 minutes. The tool incorporates disease-related, psychosocial, nutritional and functional aspects of health and fitness, and also includes measures of cognitive and physical performance.
“The Fit-Frailty app not only measures a patient's frailty, but also the change in frailty,” said Kennedy, who developed the app at the Jealous Center for Aging Research, an HHS research institute affiliated with McMaster University.
The app's co-developers are Dr George Ioannidis, Associate Director of Geras; Dr Alexandra Papaioannou, geriatrician and executive director of Geras; Dr Jonathan Adachi, rheumatologist and professor of medicine emeritus; and Dr Kenneth Lockwood, professor of medicine and geriatrician at Dalhousie University, who developed the internationally recognised frailty measure.
The Jealous team built on Lockwood's methodology to create an interactive app that can be used at the point of care. They did this by partnering with app developers at Mohawk College and the HHS Center for Data Science and Digital Health (CREATE) team. CREATE works with hospital clinicians, including physicians, to develop new ideas and create digital solutions that fundamentally rethink how health care is delivered. CREATE also works with organizations in both the public and private sectors, from local startups to national and international organizations.
The researchers received funding to develop an initial prototype from the HHS Foundation and the Center for Innovation on Aging and Brain Health.
The second version is fully virtual, and was developed specifically for researchers measuring frailty for research. “In the research world, you can download the results as a spreadsheet,” says Kennedy, a Gelas scientist who has worked in aging research for the past 20 years. She hopes other large academic health science institutions across Canada will use the app for clinical trials.
Frailty assessment
Frailty testing for physical and cognitive abilities can be overlooked because it's not part of standard medical care. The app takes testing to the next level as it can be easily accessed by healthcare professionals on their smartphone or tablet, Kennedy said, adding: “It's portable and has built-in features such as automatic timers and instructional videos to guide clinicians through the assessment process.”
Members of the restorative care allied health team at HHS St. Peter's Hospital were key clinical partners in this study.
Frail patients are at higher risk of experiencing medical complications, longer hospital stays and are more likely to be discharged to nursing homes, Kennedy said.
“Understanding a patient's frailty across the frailty spectrum and identifying areas needing intervention can help doctors and other clinicians better assess a patient's frailty and develop an individualized care plan.”
Kennedy adds that the Fit-Frailty app project is an example of research and innovation being integrated into clinical care. The project was first evaluated among outpatients at the Centre for Healthy Ageing at HHS St. Peter's Hospital, and is now being evaluated among inpatients at St. Peter's Hospital's Restorative Care Unit. This latter study is being led by Aasta Lelan, a master's student studying health research methods, evidence and impact at McMaster University.
Inpatients are assessed before starting their rehabilitation program and again just before being discharged to measure their improvement.
“This tool has already been tested and approved from a technical standpoint to be easy to use and work well,” Kennedy said. “We are now putting it to use with actual hospitalized patients to further test its usefulness.”
Kennedy added that testing the app in a real patient environment is exciting: “Researchers can't exist in a vacuum, and we're excited to be able to pilot this new innovation within HHS.”
