Roman Romero-Ortuno is a Consultant Geriatrician at Addenbrooke’s Hospital, and an Honorary Visiting Fellow at the University of Cambridge.
Roman was jointly awarded the 2015 BGS Rising Star award; in this blog he discusses his research on operationalisations of frailty in older adults and integration of care.
I am honoured to be one of the recipients of the 2015 British Geriatrics Society (BGS) Rising Star Award. I am delighted that my research contributions have been deemed to have potential for translation into improvements to the care of older people.
I am a recently appointed Consultant Geriatrician at Addenbrooke’s Hospital (Cambridge University Hospitals NHS Foundation Trust). My academic credentials include a PhD from Trinity College Dublin in the area of frailty (2011) and an MSc in European Social Policy (2003) from the London School of Economics and Political Science (LSE). I am an associate post-doctoral researcher in The Irish Longitudinal Study of Ageing (TILDA) and a user of the Survey of Health, Ageing and Retirement in Europe (SHARE). I was recently awarded an Honorary Visiting Fellowship to the Clinical Gerontology Unit in the Department of Public Health and Primary Care of the University of Cambridge.
My academic publications are in areas such as the science of frailty, the clinical translation of frailty, and the characteristics and outcomes of older people in the acute hospital. I am delighted that since 2010, my publications have received more than 500 citations internationally.
One of my core academic interests is the operationalisation of the clinical concept of frailty in ways that add value to practice and research. To date, my most impactful research contribution in that area is the Frailty Instrument for Primary Care of the Survey of Health, Ageing and Retirement in Europe (SHARE-FI). I led the development of SHARE-FI to provide community practitioners with a frailty assessment tool that can be easily scored at the point of care, with reference to a large population-based European sample. SHARE-FI is fully non-commercial and its web-based calculators are freely available to practitioners and researchers.
A consensus group consisting of delegates from six major international, European, and US societies referred to SHARE-FI as an example of a well-validated frailty model. My ongoing quest for quality and usability in primary care has led to the recent development of a sister open access instrument, the SHARE Frailty Instrument for those aged 75 or more (SHARE-FI75+). The main advantages of SHARE-FI75+ are that it does not require the assessment of handgrip strength and that it provides an age-adjusted continuous frailty score, which ranges from 0 to 1.
I am interested in exploring how operationalisations of frailty can help target hospital resources for the heterogeneous population of older people. In Addenbrooke’s Hospital, we have recently shown that the Clinical Frailty Scale may help predict in-patient mortality and target specialist geriatric resources within the hospital.
Since 2008, I have regularly contributed to BGS scientific meetings. In 2010, the BGS awarded me the Elizabeth Brown Prize for the best oral presentation at the Spring Scientific Meeting, for my study entitled Do older pedestrians have enough time to cross roads in Dublin? A critique of the Traffic Management Guidelines based on clinical research findings. I have been invited to deliver lectures on frailty for the 11th European Academy for Medicine and Ageing (EAMA) and the 2nd Barcelona International Conference on Healthy Ageing.
My current programme of work is clinically based and continues along the lines of operationalisation of frailty in older people, and its implications for clinical care provision and organisation of health and social care services. I believe that the emerging science of frailty will promote more equitable access to specialist geriatric services and more patient-centered, personalised treatment approaches.
My plans for the next 3-5 years include exploring the potential of frailty screening tools to facilitate integration of services across levels of health and social care. I envisage that efforts being made at regional levels to integrate health and social care services will require the integration of research efforts from a variety of disciplines (e.g. Hospital Medicine, General Practice, Social Policy, Public Health, and Health Services Research). I look forward to very exciting times ahead.