Frailty Other
Conditions
Interventions
Participants will be individually randomised using an automated 24 hour randomisation service on a 1.25:1 allocation ratio to either HOPE extended rehabilitation programme plus Usual Care, or Usual Ca
Sponsors
Bradford Teaching Hospitals NHS Foundation Trust
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Age 65 years and over 2. Admitted to elderly medicine / trauma & orthopaedics wards following acute illness or injury then discharged home from hospital or from intermediate care 3. Frailty, identified using a score of 5-7 on the 9-item Clinical Frailty Scale (CFS) 4. Mobility, identified by ability to complete the TUGT without additional external support (other than usual walking aids) 5. Willing and able to give informed consent to participate in the study or consultee declaration where the patient lacks capacity 6. Able to communicate by telephone (to support intervention delivery, and follow-up assessments - dependent upon allocation and method of completion)
Exclusion criteria
Exclusion criteria: 1. Permanent care home residents (but not those occupying temporary rehabilitation beds within a care home as part of intermediate care services) 2. Moderate/severe dementia at baseline* (defined as Montreal Cognitive Assessment test < 20) 3. Severe, disabling stroke at baseline* (defined as new or previous stroke with Barthel Index < 9) 4. Recent (< 3 months prior randomisation) myocardial infarction, or unstable angina 5. Another household member in the study 6. Very severe frailty (defined as score of 8 on CFS) 7. Terminally ill (defined as score of 9 on CFS) 8. Receiving palliative care 9. Referral at discharge for condition-specific rehabilitation (e.g. pulmonary rehabilitation, stroke rehabilitation) 10. Currently participating in HERO or another contraindicated study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Physical Component Summary (PCS) derived from the Short Form 36 item health questionnaire (SF36) at baseline, 6 and 12 months. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Activities of daily living using the Barthel Index of activities of daily living and the Nottingham Extended Activities of Daily Living (NEADL) at baseline, 6 and 12 months 2. Quality of Life assessed using the EuroQol 5-Dimension Health Questionnaire (EQ-5D-5L) at baseline, 6 and 12 months 3. Healthcare Resource (i.e. hospital visits, GP appointments) assessed using the Healthcare Resource Use at baseline, 6 and 12 months 4. Mental Health assessed using the SF36 Mental Component Summary (MCS) at baseline, 6 and 12 months 5. Cost effectiveness assessed using the Short-Form health survey 6 dimension score (SF6D) at baseline, 6 and 12 months 6. Intervention delivery data (adherence) will be collected from HOPE trained therapists in the form of a Therapy Record completed weekly over 24 weeks per participant 7. Exercise is assesed using a weekly exercise diary kept during the course of intervention delivery (24 weeks) | — |
Countries
England, United Kingdom
Contacts
Public ContactMatthew Prescott
Outcome results
None listed