Abstract
Introduction
Age is a risk factor for digital exclusion, but many older people have excellent access to digital services. Frailty may offer a clearer mechanism of exclusion. The aim of this study was to assess the association between living with frailty and digital exclusion from video consultation.
Methods
We undertook a multicentre cross-sectional study across primary care, interface, and secondary care services in South-West England. Patients were enrolled between 21st February and 12th April 2022. The primary outcome was complete digital exclusion from video consultation (defined as the no access for the individual and no option for help from their support network). A secondary analysis looked at digital exclusion of the individual only. Frailty was measured using the Clinical Frailty Scale. Outcomes were analysed with logistic regression.
Results
255 patients were included of which 39% were living with frailty. Only one person not living with frailty (CFS 1-3) experienced complete digital exclusion compared to 10.7% living with frailty (CFS ≥4). Frailty was not associated with complete digital exclusion, but was associated with individual digital exclusion: compared to CFS 1-3, CFS 4-5 aOR=36.5 (95%CI 4.40-304.9) and CFS 6-8 aOR=65.4 (95%CI 6.63-645.9). The imprecise estimates were caused by only one person not living with frailty digitally excluded.
Conclusion
Frailty was associated with individual digital exclusion. However, when considering a person living with frailty’s support network digital exclusion from video consultation was rare. To improve access to video consultation for people living with frailty their support network should be explored when booking appointments.