Development of an instrument for the identification of frail older people as a target population for integrated care

Janneke A. L. van Kempen*, Henk J. Schers, Anne Jacobs, Sytse U. Zuidema, Franca Ruikes, Sarah H. M. Robben, Rene J. F. Melis, Marcel G. M. Olde Rikkert

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

53 Citaten (Scopus)



Primary care is increasingly interested in the identification of frailty, as it selects the target population for integrated care. However, instruments for the identification of frailty specifically validated for use in primary care are scarce. This study developed the Easycare Two-step Older persons Screening (Easycare-TOS), which provides a valid, efficient, and pragmatic screening procedure to identify frail older people.


This paper aims to describe the development of the Easycare-TOS and the data from the pilot studies.

Design and setting

Observational pilot study in seven academic GP practices in and around Nijmegen, The Netherlands.


The Easycare-TOS was developed in a cyclic process with the input of stakeholders. In every cycle, the requirements were first defined, then translated into a prototype that was tested in a pilot study. The Easycare-TOS makes optimal use of prior knowledge of the GP, and the professionals' appraisal is decisive in the frailty decision, instead of a cut-off score. Further, it considers aspects of frailty, as well as aspects of the care context of the patient.


The pilot data have shown that after step 1, two-thirds of the patients do not need further assessment, because they are judged as not frail, based on prior knowledge of the GP. The overall prevalence of frailty in this pilot study is 24%. Most professionals who participated in the pilot studies considered the time investment acceptable and the method to be of added value.


The Easycare-TOS instrument meets the predefined efficiency, flexibility, and acceptability requirements for use as an identification instrument for frailty in primary care.

Originele taal-2English
Pagina's (van-tot)E225-E231
Aantal pagina's7
TijdschriftBritish Journal of General Practice
Nummer van het tijdschrift608
StatusPublished - mrt-2013

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