Survivorship care planning is viewed favorably by consumers, nurses, and physicians, however there are several barriers to its adoption. Barriers may be overcome with: electronic medical records, changes in reporting requirements of insurers, advocacy on the part of patients, and incorporation of care planning in education and training programs.

In patients with COPD and a history of exacerbations, a once-daily treatment regimen of combined fluticasone furoate and vilanterol was associated with a lower rate of exacerbations than usual care, without a greater risk of serious adverse events. (Funded by GlaxoSmithKline; Salford Lung Study ClinicalTrials.gov number, NCT01551758 .).

GlaxoSmithKline.

F rail older adults have complex health and social care needs, and their functional abilities often decompensate in the face of acute illness. 1 Adverse events occur in the short term (e.g., increased length of stay or hospital complications) 2 and long term (e.g., readmission or death). 3,4 One approach to quantifying frailty-associated risk has been to consider the accumulation of health deficits, as operationalized in the Frailty Index. 5 This too is well-established in community samples; however, the extent to which these risk prediction tools can be translated in the acute setting where chronic and acute issues co-exist is unclear. Understanding how to measure accumulated deficits in frail patients presenting with acute illness would be an important step toward identifying patients who require targeted interventions such as those that maximize physical and cognitive function, 6 or patients with many active health conditions. Recent studies have used laboratory investigations combined as a frailty index (the FI-Laboratory) to identify incipient frailty states that might increase risk of adverse outcomes from clinically detectable frailty. 7-14 Adapted from animal studies, 15 the human FI-Laboratory was developed and used in communitydwelling populations 9,13,14,16-18 and in older adults in institutional RESEARCH Complementing chronic frailty assessment at hospital admission with an electronic frailty index (FI-Laboratory) comprising routine blood test results