The British journal of general practice : the journal of the Royal College of General Practitioners
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Observational Study
Detection of frailty in older patients using a mobile app: cross-sectional observational study in primary care.
The main instruments used to assess frailty are the Fried frailty phenotype and the Fatigue, Resistance, Ambulation, Illnesses, and Loss of Weight (FRAIL) scale. Both instruments contain items that must be obtained in a personal interview and cannot be used with an electronic medical record only. ⋯ A points system was developed to predict frailty in older people using parameters that are easy to obtain and recorded in the clinical history. Future research should be carried out to externally validate the constructed model.
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The popularity of social prescribing has grown in recent years following a series of high-profile recommendations in scientific reviews, political reports, and media coverage. Social prescribing has the potential to address multiple health and social problems, but few studies have examined how it works. ⋯ SPA appears to benefit individuals by a process that begins with personalised professional help to address social problems and moves through engagement with activities and others, to the recognition of personal and social assets and opportunities.
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Clinical commissioning involves ethically challenging decisions about health resource allocation. However, commissioners come from a range of professional backgrounds with varying levels of training and expertise in ethical decision-making. Hence, they may lack the relevant training and resources to feel fully prepared for this increasingly demanding role. ⋯ Commissioners face complex decisions involving ethical issues, and associated moral unease is exacerbated by a lack of ethics training and lack of confidence in identifying and analysing these. This study shows a clear need for additional support and ethics training for commissioners to support them in this area of decision-making.
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High demand for health services is an issue of current importance in England, in part because of the rapidly increasing use of emergency departments (EDs) and GP practices for mental health conditions and the high cost of these services. ⋯ Mental health comorbidities increase the risk of attendances to both EDs and general practice. Further research into the social attributes that contribute to reduced ED and general practice attendance rates is needed.