Perceptions, attitudes and training needs of primary healthcare professionals in identifying and managing frailty: a qualitative study

To explore the perceptions and attitudes of primary health care (PHC) professionals towards frailty in a country where geriatrics is not recognised as a specialty, and to explore their training needs in the identification and management of frailty. The main barriers towards identifying and managing frailty are associated with the healthcare system, with the most important ones identified to be a gap in geriatric education and training of professionals, as well as problems with staffing of allied health professionals (AHPs) in community settings. However, PHC professionals are motivated and receptive to training in frailty, and they particularly value interactive learning with a focus on practical skills. There is an imperative need for education and training of PHC professionals, recruitment and training of AHPs and interdisciplinary collaboration for the delivery of person-centred care for people with frailty living in the community. Although frailty can be delayed or prevented by appropriate interventions, these are often not available in countries lacking formal education and infrastructure in geriatrics. The aim of this study was to: (a) explore ideas, perceptions and attitudes of primary health care (PHC) professionals towards frailty in a country where geriatrics is not recognised as a specialty; (b) explore PHC professionals’ training needs in frailty; and (c) define components of a frailty educational programme in PHC. Qualitative design, using two focus groups with PHC professionals conducted in Thessaloniki, Greece. Focus groups were audio recorded and transcribed. Data were analysed with thematic analysis. In total 31 PHC professionals (mean age: 46 years; gender distribution: 27 females, 4 males) participated in the study (physicians n = 17; nurses n = 12; health visitors n = 2). Four main themes were identified: (1) Perceptions and understanding of frailty; (2) Facilitators and barriers to frailty identification and management; (3) Motivation to participate in a frailty training programme; (4) Education and training. The main barriers for the identification and management of frailty were associated with the healthcare system, including duration of appointments, a focus on prescribing, and problems with staffing of allied health professionals, but also a lack of education. Training opportunities were scarce and entirely based on personal incentive. Professionals were receptive to training either face-to-face or online. A focus on learning practical skills was key. Education and training of professionals and interdisciplinary collaboration are essential and much needed for the delivery of person-centred care for people with frailty living in the community.