Home-based Extended Rehabilitation for Older people (HERO): study protocol for an individually randomised controlled multi-centre trial to determine the clinical and cost-effectiveness of a home-based exercise intervention for older people with frailty as extended rehabilitation following acute illness or injury, including embedded process evaluation

Abstract Background The majority of older people (> 65 years) in hospital have frailty and are at increased risk of readmission or death following discharge home. In the UK, following acute hospitalisation, around one third of older people with frailty are referred on for rehabilitation, termed ‘...

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Autores principales:	Matthew Prescott, Amanda Lilley-Kelly, Bonnie Cundill, David Clarke, Sian Drake, Amanda J. Farrin, Anne Forster, Madeline Goodwin, Victoria A. Goodwin, Abi J. Hall, Suzanne Hartley, Mike Holland, Claire Hulme, Silviya Nikolova, Catriona Parker, Phil Wright, Friederike Ziegler, Andrew Clegg
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Older people frailty Ageing Randomised controlled trial Exercise Physiotherapy Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/b57602d90ac148a5a0fe0b0cc2bf60d8
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spelling	oai:doaj.org-article:b57602d90ac148a5a0fe0b0cc2bf60d82021-11-14T12:31:23ZHome-based Extended Rehabilitation for Older people (HERO): study protocol for an individually randomised controlled multi-centre trial to determine the clinical and cost-effectiveness of a home-based exercise intervention for older people with frailty as extended rehabilitation following acute illness or injury, including embedded process evaluation10.1186/s13063-021-05778-51745-6215https://doaj.org/article/b57602d90ac148a5a0fe0b0cc2bf60d82021-11-01T00:00:00Zhttps://doi.org/10.1186/s13063-021-05778-5https://doaj.org/toc/1745-6215Abstract Background The majority of older people (> 65 years) in hospital have frailty and are at increased risk of readmission or death following discharge home. In the UK, following acute hospitalisation, around one third of older people with frailty are referred on for rehabilitation, termed ‘intermediate care’ services. Although this rehabilitation can reduce early readmission to hospital (< 30 days), recipients often do not feel ready to leave the service on discharge, suggesting possible incomplete recovery. Limited evidence suggests extended rehabilitation is of benefit in several conditions and there is preliminary evidence that progressive physical exercise can improve mobility and function for older people with frailty, and slow progression to disability. Our aim is to evaluate the effectiveness of the Home-based Older People’s Exercise (HOPE) programme as extended rehabilitation for older people with frailty discharged home from hospital or intermediate care services after acute illness or injury. Methods A multi-centre individually randomised controlled trial, to evaluate the clinical and cost-effectiveness of the HOPE programme. This individualised, graded and progressive 24-week exercise programme is delivered by NHS physiotherapy teams to people aged 65 and older with frailty, identified using the Clinical Frailty Scale, following discharge from acute hospitalisation and linked intermediate care rehabilitation pathways. The primary outcome is physical health-related quality of life, measured using the physical component summary score of the modified Short Form 36- item health questionnaire (SF36) at 12 months. Secondary outcomes include self-reported physical and mental health, functional independence, death, hospitalisations, care home admissions. Plans include health economic analyses and an embedded process evaluation. Discussion This trial seeks to determine if extended rehabilitation, via the HOPE programme, can improve physical health-related quality of life for older people with frailty following acute hospitalisation. Results will improve awareness of the rehabilitation needs of older people with frailty, and provide evidence on the clinical and cost-effectiveness of the targeted exercise intervention. There is potential for considerable benefit for health and social care services through widespread implementation of trial findings if clinical and cost-effectiveness is demonstrated. Trial registration ISRCTN 13927531 . Registered on April 19, 2017.Matthew PrescottAmanda Lilley-KellyBonnie CundillDavid ClarkeSian DrakeAmanda J. FarrinAnne ForsterMadeline GoodwinVictoria A. GoodwinAbi J. HallSuzanne HartleyMike HollandClaire HulmeSilviya NikolovaCatriona ParkerPhil WrightFriederike ZieglerAndrew CleggBMCarticleOlder peoplefrailtyAgeingRandomised controlled trialExercisePhysiotherapyMedicine (General)R5-920ENTrials, Vol 22, Iss 1, Pp 1-17 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Older people frailty Ageing Randomised controlled trial Exercise Physiotherapy Medicine (General) R5-920
spellingShingle	Older people frailty Ageing Randomised controlled trial Exercise Physiotherapy Medicine (General) R5-920 Matthew Prescott Amanda Lilley-Kelly Bonnie Cundill David Clarke Sian Drake Amanda J. Farrin Anne Forster Madeline Goodwin Victoria A. Goodwin Abi J. Hall Suzanne Hartley Mike Holland Claire Hulme Silviya Nikolova Catriona Parker Phil Wright Friederike Ziegler Andrew Clegg Home-based Extended Rehabilitation for Older people (HERO): study protocol for an individually randomised controlled multi-centre trial to determine the clinical and cost-effectiveness of a home-based exercise intervention for older people with frailty as extended rehabilitation following acute illness or injury, including embedded process evaluation
description	Abstract Background The majority of older people (> 65 years) in hospital have frailty and are at increased risk of readmission or death following discharge home. In the UK, following acute hospitalisation, around one third of older people with frailty are referred on for rehabilitation, termed ‘intermediate care’ services. Although this rehabilitation can reduce early readmission to hospital (< 30 days), recipients often do not feel ready to leave the service on discharge, suggesting possible incomplete recovery. Limited evidence suggests extended rehabilitation is of benefit in several conditions and there is preliminary evidence that progressive physical exercise can improve mobility and function for older people with frailty, and slow progression to disability. Our aim is to evaluate the effectiveness of the Home-based Older People’s Exercise (HOPE) programme as extended rehabilitation for older people with frailty discharged home from hospital or intermediate care services after acute illness or injury. Methods A multi-centre individually randomised controlled trial, to evaluate the clinical and cost-effectiveness of the HOPE programme. This individualised, graded and progressive 24-week exercise programme is delivered by NHS physiotherapy teams to people aged 65 and older with frailty, identified using the Clinical Frailty Scale, following discharge from acute hospitalisation and linked intermediate care rehabilitation pathways. The primary outcome is physical health-related quality of life, measured using the physical component summary score of the modified Short Form 36- item health questionnaire (SF36) at 12 months. Secondary outcomes include self-reported physical and mental health, functional independence, death, hospitalisations, care home admissions. Plans include health economic analyses and an embedded process evaluation. Discussion This trial seeks to determine if extended rehabilitation, via the HOPE programme, can improve physical health-related quality of life for older people with frailty following acute hospitalisation. Results will improve awareness of the rehabilitation needs of older people with frailty, and provide evidence on the clinical and cost-effectiveness of the targeted exercise intervention. There is potential for considerable benefit for health and social care services through widespread implementation of trial findings if clinical and cost-effectiveness is demonstrated. Trial registration ISRCTN 13927531 . Registered on April 19, 2017.
format	article
author	Matthew Prescott Amanda Lilley-Kelly Bonnie Cundill David Clarke Sian Drake Amanda J. Farrin Anne Forster Madeline Goodwin Victoria A. Goodwin Abi J. Hall Suzanne Hartley Mike Holland Claire Hulme Silviya Nikolova Catriona Parker Phil Wright Friederike Ziegler Andrew Clegg
author_facet	Matthew Prescott Amanda Lilley-Kelly Bonnie Cundill David Clarke Sian Drake Amanda J. Farrin Anne Forster Madeline Goodwin Victoria A. Goodwin Abi J. Hall Suzanne Hartley Mike Holland Claire Hulme Silviya Nikolova Catriona Parker Phil Wright Friederike Ziegler Andrew Clegg
author_sort	Matthew Prescott
title	Home-based Extended Rehabilitation for Older people (HERO): study protocol for an individually randomised controlled multi-centre trial to determine the clinical and cost-effectiveness of a home-based exercise intervention for older people with frailty as extended rehabilitation following acute illness or injury, including embedded process evaluation
title_short	Home-based Extended Rehabilitation for Older people (HERO): study protocol for an individually randomised controlled multi-centre trial to determine the clinical and cost-effectiveness of a home-based exercise intervention for older people with frailty as extended rehabilitation following acute illness or injury, including embedded process evaluation
title_full	Home-based Extended Rehabilitation for Older people (HERO): study protocol for an individually randomised controlled multi-centre trial to determine the clinical and cost-effectiveness of a home-based exercise intervention for older people with frailty as extended rehabilitation following acute illness or injury, including embedded process evaluation
title_fullStr	Home-based Extended Rehabilitation for Older people (HERO): study protocol for an individually randomised controlled multi-centre trial to determine the clinical and cost-effectiveness of a home-based exercise intervention for older people with frailty as extended rehabilitation following acute illness or injury, including embedded process evaluation
title_full_unstemmed	Home-based Extended Rehabilitation for Older people (HERO): study protocol for an individually randomised controlled multi-centre trial to determine the clinical and cost-effectiveness of a home-based exercise intervention for older people with frailty as extended rehabilitation following acute illness or injury, including embedded process evaluation
title_sort	home-based extended rehabilitation for older people (hero): study protocol for an individually randomised controlled multi-centre trial to determine the clinical and cost-effectiveness of a home-based exercise intervention for older people with frailty as extended rehabilitation following acute illness or injury, including embedded process evaluation
publisher	BMC
publishDate	2021
url	https://doaj.org/article/b57602d90ac148a5a0fe0b0cc2bf60d8
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