Sunfrail - Reference Sites Network for Prevention and Care of Frailty and Chronic Conditions in community
The proposal is promoted by a network of EIP-AHA Italian Reference Sites with the intent to validate and standardize approaches on frailty and multimorbidity by building on the instruments developed with the European Commission Innovation Partnership on Active and Healthy Ageing. Key-partners of the project are mainly EIP-AHA Reference Sites (and AG Coordinators: A1, A3, B3), representing countries from the northern, southern and eastern part of Europe. Proposed actions will support the development, validation and experimentation of a model to improve the detection, prevention and care of frailty and management of multimorbidity in EU countries, providing partners with different approaches to care from which to adopt/adapt their own systems/services. The model will be experimented in selected RS. It will support the development of innovative tools for the prediction of frailty and multimorbidity by level of care, focussing on community based prevention and avoidable hospitalization. The involvement of European networks (EUREGHA), and of the International Scientific Research Networks in the field of frailty and disability (IAGG-GARN), will grant necessary scientific support and advocacy for a real EU and international value.Project’s Main Outcomes: 1) A shared model of references on frailty and multimorbidity. 2) A tool kit for the prediction of frailty and multimorbidity by level of care. Primary care: easy to use tool to assess risks of frailty through the physical function (slow gait speed, others); tools to support the design of information systems and care pathways for the management of chronic diseases. Secondary-tertiary level: identification of methods and instruments to predict multimorbidity. Other tools: instruments for professional’s skills improvement and analysis of costs.