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In this case study we describe how Sydney Local Health District (SLHD) Disability Inclusion and Advice Service (DIAS) provided support to disability group homes during the COVID-19 Delta and Omicron waves. The study provides insights into group home providers' experience of supports implemented by SLHD and other stakeholders. A mixed method approach was undertaken that included analysing data from a database and electronic medical records and a survey of disability group home managers. DIAS developed a range of processes to support prevention, outbreak preparedness and response. This included developing a Disability Shared Living COVID-19 Pathway, engaging with group home providers through a fortnightly Community of Practice, assisting with improving vaccination status and procuring personal protective equipment. During an outbreak DIAS provided a 24 h, 7 days per week on call support, coordinated outbreak management team meetings and collaborated with several internal and external stakeholders. SLHD infection prevention and control nurses were recruited to undertake a process of reviewing outbreak management plans and providing support during an outbreak. Most disability providers (86%) reported that they felt very prepared to manage outbreaks at the time of the survey (August 2022) compared with the pre-Delta wave, for which 36% reported feeling 'not prepared'. The proportion who rated the support from the stakeholders as very supportive/supportive was as follows: SLHD (100%), NSW Health (64%), National Disability Insurance Agency (50%) and National Disability Insurance Scheme Quality & Safeguards Commission (37%). Our case study provides insights into the support that LHDs can provide to disability homes in response to future outbreaks. What is known about the topic? People with a disability (PWD) are at higher risk of morbidity and mortality following COVID-19 infection but little is known about how PWD were supported during the COVID-19 pandemic. What does this paper add? Describes one local health district (LHD's) approach to prevent, manage and minimise COVID-19 outbreaks in disability group homes along with insights from the disability group home managers on their experience of support provided by the LHD and other stakeholders. What are the implications for practitioners? Awareness of effective strategies supporting PWD that could be replicated in health organisations. [ABSTRACT FROM AUTHOR]

Background: Frailty is an important determinant of health‐care needs and outcomes for people in hospital. Objectives: To compare characteristics and predictive ability of a multidomain frailty index derived from routine health data (electronic frailty index‐acute hospital; eFI‐AH) with the hospital frailty risk score (HFRS). Methods: This retrospective study included 6771 patients aged ≥75 years admitted to an Australian metropolitan tertiary referral hospital between October 2019 and September 2020. The eFI‐AH and the HFRS were calculated for each patient and compared with respect to characteristics, agreement, association with age and ability to predict outcomes. Results: Median eFI‐AH was 0.17 (range 0–0.66) whilst median HFRS was 3.2 (range 0–42.9). Moderate agreement was shown between the tools (Pearson's r 0.61). After adjusting for age and gender, both models had associations with long hospital stay, in‐hospital mortality, unplanned all‐cause readmission and fall‐related readmission. Specifically, the eFI‐AH had the strongest association with in‐hospital mortality (adjusted odds ratio (aOR) 2.81, 95% confidence intervals (CI) 2.49–3.17), whilst the HFRS was most strongly associated with long hospital stay (aOR 1.20, 95% CI 1.18–1.21). Both tools predicted hospital stay >10 days with good discrimination and calibration. Conclusions: Although the eFI‐AH and the HFRS did not consistently identify the same inpatients as frail, both were associated with adverse outcomes and they had comparable predictive ability for prolonged hospitalisation. These two constructs of frailty may have different implications for clinical practice and health service provision and planning. [ABSTRACT FROM AUTHOR]

Background: Deprescribing is an intervention to address the high prevalence of inappropriate polypharmacy in older people living in residential aged care facilities (RACFs). Many deprescribing interventions are complex and involve several stages including initial pharmacist recommendation, subsequent acceptance of the recommendations by a prescriber and the patient, and then actual implementation., Objectives: This study aimed to investigate pharmacist deprescribing recommendations for residents within RACFs, general practitioner (GP) acceptance, and the actual implementation of the accepted recommendations at 12-month., Methods: The intervention occurred as part of a randomised controlled trial and comprised a pharmacist-led medication review using an evidence-based algorithm, with the focus on identifying medications to potentially deprescribe. Consent to participate was obtained from residents (or surrogate decision-makers), RACF nursing staff and the resident's GP. Deprescribing recommendations were reviewed by GPs before implementation as part of the intervention and control arms of the trial, although control group participants continued to receive their usual medications in a blinded manner., Results: There were 303 participants enrolled in the study, and 77% (941/1222) of deprescribing recommendations suggested by the pharmacists were accepted by GPs. Of the recommendations accepted by GPs, 74% (692/ 941) were successfully implemented at the end of the follow-up visit at 12 months. The most common reason for deprescribing was because medications were no longer needed (42%, 513/ 1231)., Conclusion: Pharmacist-led deprescribing recommendations arising from an algorithm-based medication review are acceptable to doctors and can have a significant impact on reducing the number of inappropriate medications consumed by older people in RACFs., Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12613001204730., (Copyright © 2022 Elsevier B.V. All rights reserved.)