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Applications of Claims-Based Frailty Index to Advance Evidence for Frailty-Guided Decision-Making

Award Number: R01AG071809
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2021
PERIOD OF PERFORMANCE END DATE: 05/31/2026

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Applications of Claims-Based Frailty Index to Advance Evidence for Frailty-Guided Decision-Making - PROJECT SUMMARY/ABSTRACT Older adults with frailty are more likely to experience poor health outcomes after acute illnesses, drug-related adverse events, and surgeries. Health care costs for frail patients double due to acute hospital care, post-acute care, and treatments for preventable conditions. Despite clinical and societal consequences of frailty, frailty is rarely assessed in clinical practice and little evidence exists on how to integrate frailty to inform clinical care and population health management. The critical step to generate this evidence is to measure frailty on a large scale with high accuracy and efficiency. To address this need, the investigator team recently developed and validated a claims-based frailty index (CFI), which enables measurement of frailty from Medicare data for large populations when in-person assessment is not feasible. The objective of this application is to generate evidence needed for frailty-guided clinical care and population health management by applying CFI to claims data-based studies of drug therapy; pragmatic clinical trials of procedural therapy; and electronic health records (EHR)-Medicare linked data of a health care system. The central hypothesis is that frailty information will improve care of older adults by uncovering meaningful variations in the treatment benefit-harm profile, costs, and resource needs. To test this hypothesis, the investigator team with extensive expertise in frailty, pharmacoepidemiologic methods, and health services research will accomplish the following specific aims in the next 5 years: 1) determine how frailty changes the benefits and harms of 10 prescription drugs for chronic conditions in older adults by applying CFI to the 2014-2022 5% Medicare random sample; 2) determine how frailty changes the benefits and harms of procedural therapies in older adults by applying CFI to Medicare data linked to 2 ongoing pragmatic clinical trials of endovascular vs surgical revascularization therapy for peripheral arterial disease and acupuncture vs usual care for chronic low back pain; and 3) determine whether implementing CFI to EHR-Medicare linked data can predict high-cost and high-need patients in a large health care system in Boston, Massachusetts. The innovative applications of CFI are readily scalable to claims-based comparative effectiveness and safety studies, clinical trials, and EHR in health care systems. The impact of this research is significant because the clinically actionable evidence generated from this research can enable optimal choice of drug and procedural therapy and a health system-wide risk stratification based on frailty. Ultimately, these results will accelerate integration of frailty in routine care and facilitate frailty-guided clinical care and population health management.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $636,192 )
2024	2024	HEBREW REHABILITATION CENTER	1200 CENTRE ST	ROSLINDALE	MA	02131	SUFFOLK	USA	Aging Research	000	4	6/21/2024	NON-COMPETING CONTINUATION	$636,192
														Subtotal = $636,192

Issue Date FY: 2023 ( Subtotal = $563,288 )
2023	2023	HEBREW REHABILITATION CENTER	1200 CENTRE ST	ROSLINDALE	MA	02131	SUFFOLK	USA	Aging Research	000	3	6/14/2023	NON-COMPETING CONTINUATION	$563,288
														Subtotal = $563,288

Issue Date FY: 2022 ( Subtotal = $1,029,944 )
2022	2022	HEBREW REHABILITATION CENTER FOR AGED, INC.	1200 CENTRE ST	BOSTON	MA	02131	SUFFOLK	USA	Aging Research	001	2	6/22/2022	SUPPLEMENT FOR EXPANSION	$397,314
2022	2022	HEBREW REHABILITATION CENTER FOR AGED, INC.	1200 CENTRE ST	BOSTON	MA	02131	SUFFOLK	USA	Aging Research	000	2	6/8/2022	NON-COMPETING CONTINUATION	$632,630
2022	2021	HEBREW REHABILITATION CENTER FOR AGED, INC.	1200 CENTRE ST	BOSTON	MA	02131	SUFFOLK	USA	Aging Research	002	1	7/25/2022	NEW	$0
														Subtotal = $1,029,944

Issue Date FY: 2021 ( Subtotal = $651,867 )
2021	2021	HEBREW REHABILITATION CENTER FOR AGED, INC.	1200 CENTRE ST	BOSTON	MA	02131	SUFFOLK	USA	Aging Research	000	1	8/26/2021	NEW	$651,867
														Subtotal = $651,867

Grand Total All Awards = $2,881,291

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Applications of Claims-Based Frailty Index to Advance Evidence for Frailty-Guided Decision-Making

Award Number: R01AG071809

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/01/2021

PERIOD OF PERFORMANCE END DATE: 05/31/2026

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