A randomized controlled pilot trial of interventions to improve functional recovery after hospitalization in older adults: Feasibility and adherence

Rachel R. Deer, Shawn M. Goodlett, Steve R. Fisher, Jacques Baillargeon, Jared Dickinson, Mukaila Raji, Elena Volpi

    Research output: Contribution to journalArticle

    8 Citations (Scopus)

    Abstract

    Background: Hospitalization is a major risk factor for functional decline, disability, loss of independence, and mortality in older adults. Evidence-based interventions to improve functional recovery from hospitalization are difficult to evaluate and implement in geriatric patients. The goal of this pilot study was to test the feasibility of recruiting geriatric inpatients and implementing pragmatic interventions to improve physical function following hospitalization. Methods: Enrolled subjects were randomized to one of five 30-day posthospitalization interventions: isocaloric placebo (P), whey protein supplement (W), in-home rehabilitation+placebo (R+P), rehabilitation+whey protein (R+W), or testosterone (T). Data were collected from a single-site university hospital to determine: (i) institution-based feasibility (nonmodifiable factors including number of patients screened, eligible, contacted) and (ii) patient-based feasibility (modifiable factors including number of patients refusing, enrolled, randomized, intervention adherence, and withdrawal). Results: From January 2014 to July 2016, 4,533 patients were chart screened; 594 (13.1%) were eligible to participate; 384 eligible subjects were contacted; 113 were enrolled; and 100 were randomized. Supplement adherence was 75% and was not different by age, education, level of independence, depression, supplement type, or dual intervention, but was significantly higher in subjects who completed the intervention (p < .01). Rehabilitation session adherence was 77% and did not vary significantly by age, education, level of independence, depression, or supplement type, but was significantly higher for sessions directly supervised (p < .01). Adherence was 100% in the testosterone arm with 94.7% of injections given within 24 hours of discharge. Conclusions: Findings from this clinical trial indicate that posthospitalization interventions in geriatric patients are feasible at both the institution and patient level.

    Original languageEnglish (US)
    Pages (from-to)187-193
    Number of pages7
    JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
    Volume73
    Issue number2
    DOIs
    StatePublished - Mar 1 2018

    Fingerprint

    Hospitalization
    Randomized Controlled Trials
    Geriatrics
    Rehabilitation
    Testosterone
    Placebos
    Education
    Inpatients
    Clinical Trials
    Injections
    Mortality
    Whey Proteins

    Keywords

    • Hospitalization
    • Protein
    • Rehabilitation
    • Testosterone

    ASJC Scopus subject areas

    • Aging
    • Geriatrics and Gerontology

    Cite this

    A randomized controlled pilot trial of interventions to improve functional recovery after hospitalization in older adults : Feasibility and adherence. / Deer, Rachel R.; Goodlett, Shawn M.; Fisher, Steve R.; Baillargeon, Jacques; Dickinson, Jared; Raji, Mukaila; Volpi, Elena.

    In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences, Vol. 73, No. 2, 01.03.2018, p. 187-193.

    Research output: Contribution to journalArticle

    Deer, Rachel R. ; Goodlett, Shawn M. ; Fisher, Steve R. ; Baillargeon, Jacques ; Dickinson, Jared ; Raji, Mukaila ; Volpi, Elena. / A randomized controlled pilot trial of interventions to improve functional recovery after hospitalization in older adults : Feasibility and adherence. In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences. 2018 ; Vol. 73, No. 2. pp. 187-193.
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    AU - Deer, Rachel R.

    AU - Goodlett, Shawn M.

    AU - Fisher, Steve R.

    AU - Baillargeon, Jacques

    AU - Dickinson, Jared

    AU - Raji, Mukaila

    AU - Volpi, Elena

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    AB - Background: Hospitalization is a major risk factor for functional decline, disability, loss of independence, and mortality in older adults. Evidence-based interventions to improve functional recovery from hospitalization are difficult to evaluate and implement in geriatric patients. The goal of this pilot study was to test the feasibility of recruiting geriatric inpatients and implementing pragmatic interventions to improve physical function following hospitalization. Methods: Enrolled subjects were randomized to one of five 30-day posthospitalization interventions: isocaloric placebo (P), whey protein supplement (W), in-home rehabilitation+placebo (R+P), rehabilitation+whey protein (R+W), or testosterone (T). Data were collected from a single-site university hospital to determine: (i) institution-based feasibility (nonmodifiable factors including number of patients screened, eligible, contacted) and (ii) patient-based feasibility (modifiable factors including number of patients refusing, enrolled, randomized, intervention adherence, and withdrawal). Results: From January 2014 to July 2016, 4,533 patients were chart screened; 594 (13.1%) were eligible to participate; 384 eligible subjects were contacted; 113 were enrolled; and 100 were randomized. Supplement adherence was 75% and was not different by age, education, level of independence, depression, supplement type, or dual intervention, but was significantly higher in subjects who completed the intervention (p < .01). Rehabilitation session adherence was 77% and did not vary significantly by age, education, level of independence, depression, or supplement type, but was significantly higher for sessions directly supervised (p < .01). Adherence was 100% in the testosterone arm with 94.7% of injections given within 24 hours of discharge. Conclusions: Findings from this clinical trial indicate that posthospitalization interventions in geriatric patients are feasible at both the institution and patient level.

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