Addresing frailty at EU level the ADVANTAGE JA work Webinar, Integrated care matters 17 th January 2019 Inés García-Sánchez, Deputy-Coordinator ADVANTAGE JA
ADVANTAGE JA I will speak about ….. • Why address Frailty at EU level? • ADVANTAGE JA • What have we been working on ? • Key messages • Integrated care & frailty
Why frailty at EU level ? 4 ideas to consider Work will consider: Frailty is a public MS individualities • Work should be health problem and EC funded • progress from: societal challenge in projects EIP on AHA AG • Europe that can be The EC supports MS to 2014 Council • Frailty prevented & will work on a EU policy to Conclusions Scientific evidence • benefit from a prevent frailty 2014 SPC LTC • European approach report Building a European approach to tackle frailty at national level
A 2017 a 2019 Co-financed by EEMM & UE PSP 2014-2020 22 EEMM Coordinated by Spain
Objectives ADVANTAGE JA aims at building a common understanding on frailty to 1. To promote important sustainable be used in Member States, by policy changes in the organization and makers and other stakeholders, … implementation of care in the Health …. and Social Systems. ….which should be the base for a common management both at 2. To prepare a common European framework on screening, early individual and population level of diagnosis, prevention, assessment and older people who are frail or at risk management of frailty. of developing frailty throughout the European Union. 3. To develop a common strategy on frailty prevention and management, including raising awareness and advocacy among stakeholders, especially policy and decision makers.
Target groups 1. Policy makers and stakeholders , both from the public and private sectors. 2. Health and Social care professionals. 3. Frail older people and their carers , those at risk of frailty, and the EU population at large.
ADVANTAGE JOINT ACTION How are we structured ? / Work packages Horizontal work packages (WP1 coordination + WP2 dissemination+ WP3 evaluation) Knowing frailty at an individual level WP4 JA on Frailty Prevention • It will develop the concept of the ‘Prevention of Frailty Approach’ in Knowing frailty at a population level WP5 health and social care services. • It will build consensus on the convenience of addressing frailty Treating/approaching frailty at an individual level WP6 independently from long-term conditions & Chronic Diseases. Models of care to prevent, delay or treat frailty WP7 Extending and expanding the knowledge on frailty WP8
IMPLEMENTATION PROCESS Phase I (2017) - State of the Art - background Phase II (2018) - information collection, developing and testing Phase III (2019) - drafting analysis and rational the draft version of the discussion and drafting final documents, debating common European of preliminary these with participant model to approach documents. MSs, and drafting the frailty (frailty prevention final framework, the FPA approach – FPA document and policy document). recommendations.
Estrategies/ synergies Active participation of stakeholders Maximize resources (building on previous work & evidence Translate evidence into policy action Create awareness Disseminate results External expertise to improve/validate
What have we been doing ? Working on frailty prevention by Intervention Implementing Prevention results • Diagnosis • Analysis Awareness • Treatment • National • Understanding frailty • Clinical pathways • structures/plans Framing the concept • Services organization • Capacity building • Facilitators/barriers • to change "Frailty prevention approach" at EU level
State of the art in Frailty (SoAR) The ADVANTAGE JA’s State of the Art report ( SoAR) … Is the first concrete step towards a common approach to tackle frailty at the European level. It offers an overview of evidence on what really works and what is unknown in terms of frailty prevention and management. It is an updated theoretical basis to inform our subsequent work.
MS survey on frailty Survey : “The MS survey on background situation in relation to the prevention and management of frailty”. • Partners collected information about the current approaches (strategies, policies, programmes, actions) that address frailty in the participating MSs and their regions by a specific survey addressed to key informants. • The data and information about frailty in each MS are based on the responses to the survey completed by each JA partner and the subsequent situation report based on the information gathered. • Took place from September 2017 to May 2018. • Resulted in a number of internal documents to be used as sources for the FPA.
The Frailty Prevention Approach (FPA) doc The FPA will give support to: • Identify national/regional areas of action on frailty and position these within the MS health priorities. • Set national/ regional objectives and deliverables for the specific areas of action. • Implement proven interventions to : • reduce risk factors for frailty. • manage frailty at individual level. • train the health workforce. • Advance action beyond the health sector through multi-sector co- operation. • Promote international collaboration across regions within participant MS to transfer and scale-up best practices.
2017, collecting & selecting evidence 2018, working towards a new approach Scientific evidence SoAR MS survey on real situation EP Information analysis & internal discussion FPA draft elaboration EAB Madrid Forum FPA presentation & debate Face up to Frailty Campaign
Key messages 1 • Demographic ageing is a serious challenge that Europe is currently facing. • Older people are at greatest risk of becoming frail and developing disability. • Multi-morbidity, disability and frailty are distinct clinical entities. They need to be distinguish: Frailty is a better predictor of good functioning than diseases. • Frailty is rather common: across Europe, 1/10 aged 65+ years is frail. • Frailty is a potentially reversible condition, especially if in its early stages. • Physical activity and exercise can support reversing the frailty status. • Health care and social system need to be adapted to manage frailty adequately.
Key messages 2 • Make frailty prevention a public health priority at EU level. • Involve civil society and a wide range of stakeholders. • Ensure Policy is both person centred and population focused. • Embed systematic screening to enable timely identification of frail older people. • Offer prevention and early intervention based on CGA to optimise function. • Design and deliver integrated person centred models of support and services. • Support adequate training of the health and care workforce. • Invest in research and evaluation on frailty. • Support adoption of ICTs and technological solutions.
enablers 1. Strong political support 2. Legislative frameworks 3. Financial incentives 4. Leadership and support to change the professional culture 5. Screening and risk prediction tools to select frail older people for interventions 6. Person centred and holistic approaches
COMPONENTS OF EFFECTIVE MODELS OF CARE FOR FRAILTY • A single entry point in the community, generally in Primary Care. • Use of simple frailty specific screening tools. • Comprehensive assessment and individualised care plans, including for caregivers. • Tailored interventions by an interdisciplinary team, both in hospitals and community. • Case management and coordination of support across the continuum of providers. • Effective management of transitions between care teams and settings. • Shared electronic information tools and technology enabled care solutions. • Clear policies and procedures for service eligibility and care processes.
ADVANTAGE JA vision is… an EU where older people live well and remain independent for longer Action based on evidence, but focused on people & working with people
Frailty allows us to reflect, plan and act on ageing moving beyond cronological age ! www.advantage.eu !!Thank you !!
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