Canadian Frailty Network to scale up efforts to improve health of older frail Canadians

The Canadian Frailty Network (CFN) will use its second five-year cycle to expand the generation and dissemination of its research to achieve better outcomes for a highly under-recognized clinical syndrome in which people are afflicted with multiple health impairments. CFN has aligned itself with an array of partners including the Canadian Institute for Health Information (CIHI) and the Canadian Longitudinal Study on Aging to demonstrate better approaches to health funding and optimize patient-centered outcomes.

CFN received $23.9 million from the Networks of Centres of Excellence (NCE) for a second five-year cycle (2017-2022) and has more than matched the federal funding with $30 million in cash and in-kind commitments from more than 150 partners.

Those diagnosed as frail are generally, but not exclusively, older patients who are poorly served by the current health system and how funding is allocated.

“Not all aging is equal …, We need to fund larger-scale studies to demonstrate that change is possible and …  measure older adults who are in a higher state of vulnerability,” says Dr John Muscedere,” CFN’s scientific director and CEO, a critical care physician at Kingston General Hospital and a professor with Queen’s Univ’s Faculty of Health Sciences where CFN is headquartered. “The concept of frailty is increased vulnerability … We will deliver original evidence, look at best practices and formulate evidence-based guidelines and indicators. CIHI will then implement these measures.”

CFN is one of two NCEs that were successful in receiving a second tranche of funding in the most recent renewal competition. Dalhousie Univ-based MEOPAR (Marine Environmental Observation Prediction and Response Network) was also successful in its renewal bid (see related article in this issue) but McGill Univ-based BioFuelNet was not renewed and will be wound down. The results of the competition were made known to participants last November but not made public until March 1.

CFN now has an ecosystem of more than 3,500 people including 400 researchers. In its first cycle, it trained more than 550 students at 44 participating post-secondary institutions and teaching hospitals. The challenge now is to translate Canada’s leadership in frailty research into application, closing the gap with other nations that have more effective policies for system-wide translation of research into practice.

“During the first five years, we worked to recruit a coalition of partners and catalyze original research and improve the core. We funded 88 research studies and spent $12 million on original research augmented by $7 million in partner funding and $10 million from other sources,” says Muscedere. “For cycle II we’re scaling up. It’s a stepwise process … We want to increase the tent across disciplines and be broadly inclusive. It makes a great deal of sense for CFN.”

In a recent opinion article co-authored by Dr Samir Sinha, director of Geriatrics at Mount Sinai Hospital and the University Health Network, Muscedere called for a major change in how federal Health Accord funding is allocated across the country. Rather than funding the provinces on a per capita basis, Muscedere says frailty should be systematically recognized so that critical funding is delivered to the regions where frailty is most pronounced and under- or mistreated.

“Per capita models fundamentally ignore the sometimes extreme variations in socio-economic, demographic and health status of regional populations across Canada —a significant oversight,” write Muscedere and Sinha. “Frailty (is) an essential concept that needs more attention in our health system in order to direct our precious health care dollars efficiently — and to provide the right care at the right time to the right populations.”

“Frailty needs to be a priority in the Canada Health Accord with resource utilization for people who are frail ,” says Muscedere."

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