Rachel R Deer1, Shawn M Goodlett1, Steve R Fisher1,2, Jacques Baillargeon3, Jared M Dickinson4, Mukaila Raji1,5, Elena Volpi1,5. 1. Sealy Center on Aging, The University of Texas Medical Branch, Galveston. 2. Department of Physical Therapy, The University of Texas Medical Branch, Galveston. 3. Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston. 4. School of Nutrition and Health Promotion, Healthy Lifestyles Research Center, Arizona State University, Phoenix. 5. Department of Internal Medicine, Division of Geriatrics, The University of Texas Medical Branch, Galveston.
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 andimplementing 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.
RCT Entities:
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.
Authors: Arny A Ferrando; Melinda Sheffield-Moore; Catherine W Yeckel; Charles Gilkison; Jie Jiang; Alison Achacosa; Steven A Lieberman; Kevin Tipton; Robert R Wolfe; Randall J Urban Journal: Am J Physiol Endocrinol Metab Date: 2002-03 Impact factor: 4.310
Authors: Kathryn Anzuoni; Terry S Field; Kathleen M Mazor; Yanhua Zhou; Lawrence D Garber; Alok Kapoor; Jerry H Gurwitz Journal: J Am Geriatr Soc Date: 2020-07-25 Impact factor: 5.562
Authors: Rachel R Deer; Jared M Dickinson; Jacques Baillargeon; Steven R Fisher; Mukaila Raji; Elena Volpi Journal: J Gerontol A Biol Sci Med Sci Date: 2019-09-15 Impact factor: 6.053
Authors: Melissa M Markofski; Kristofer Jennings; Kyle L Timmerman; Jared M Dickinson; Christopher S Fry; Michael S Borack; Paul T Reidy; Rachel R Deer; Amanda Randolph; Blake B Rasmussen; Elena Volpi Journal: J Gerontol A Biol Sci Med Sci Date: 2019-09-15 Impact factor: 6.053
Authors: Maria Amasene; Ariadna Besga; Iñaki Echeverria; Miriam Urquiza; Jonatan R Ruiz; Ana Rodriguez-Larrad; Mikel Aldamiz; Pilar Anaut; Jon Irazusta; Idoia Labayen Journal: Nutrients Date: 2019-10-01 Impact factor: 5.717