Addressing Frailty in Cardiology: Identifying Barriers Faced by Cardiologists and Healthcare Professionals in Asia (JACC Asia November2025)-Articlle: Addressing Frailty in Cardiology: Identifying Barriers Faced by Cardiologists and Healthcare Professionals in Asia

Articlle: Addressing Frailty in Cardiology: Identifying Barriers Faced by Cardiologists and Healthcare Professionals in Asia

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This multinational study surveyed 238 healthcare professionals across Asia, including 59 cardiologists, to identify barriers to implementing frailty management in cardiology practice. Frailty—an important predictor of adverse outcomes in older adults with cardiovascular disease—has received growing attention due to its impact on mortality and treatment effectiveness. Despite consensus guidelines recommending frailty screening and intervention, real-world application remains limited.<br /><br />Key findings reveal that about one-quarter of respondents lacked confidence in identifying (22.7%) or treating (28.2%) frailty, with many uncertain about screening tools (34.9%) and subsequent care steps (37.8%). Cardiologists, compared to other physicians, reported lower awareness of which patients require screening (74.6% vs 88.6%) and which tools to use (61.0% vs 79.8%), and were more likely to feel too busy to manage frailty (22% vs 10.5%). Nurses, in contrast, experienced fewer communication challenges within multidisciplinary teams and felt less time pressure managing frailty. Limited multidisciplinary support (21%), resource constraints (52.9%), communication difficulties (45.8%), patient and caregiver resistance (21.8%), and insufficient community care collaborations (39.5%) were additional obstacles.<br /><br />The study underscores frailty’s multidimensional nature—encompassing physical, cognitive, nutritional, and psychosocial domains—and the complexity of integrating its assessment and management into busy cardiology workflows. To overcome barriers, a comprehensive, multifaceted implementation strategy is recommended. This includes enhanced education and training for healthcare providers, clearer clinical workflows and guidelines, proactive and accessible multidisciplinary cardiogeriatric teams, greater involvement of nurses and allied health professionals, improved patient and caregiver education, and leveraging digital health technologies to streamline assessments and remote monitoring.<br /><br />Limitations include the survey’s self-reported nature, limited representation beyond East and Southeast Asia, and varying frailty assessment tools, which may affect generalizability. Nevertheless, findings highlight critical gaps at provider, institutional, and systemic levels. Addressing these through tailored interventions and collaborative care models may enhance frailty recognition and management in cardiology, ultimately improving outcomes for aging cardiovascular populations. Further research, especially implementation trials, is needed to validate effective strategies.

Keywords

frailty management

cardiology practice

healthcare professionals

frailty screening

multidisciplinary teams

barriers to implementation

cardiologists

nurses

cardiogeriatric teams

digital health technologies