通过实施运动、营养和减药来降低虚弱程度（FRIEND）试验：研究方案与招募结果

The Frailty Reduction via Implementation of Exercise, Nutrition, and Deprescribing (FRIEND) Trial: Study Protocol and Recruitment Results.

作者信息

Inskip Michael, Almendrales Rangel Carolina, Njoku Chidiamara Maria, Barnett Fiona, Shih Isabel, O'Neill Leonie, Fiatarone Singh Maria A, Valenzuela Trinidad

机构信息

College of Healthcare Sciences, James Cook University, Townsville, QLD 4814, Australia.

School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia.

出版信息

Methods Protoc. 2024 Mar 22;7(2):26. doi: 10.3390/mps7020026.

DOI:10.3390/mps7020026

PMID:38525784

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10961770/

Abstract

INTRODUCTION

Virtually all adults in aged care facilities are frail, a condition which contributes to falls, cognitive decline, hospitalisation, and mortality. Polypharmacy, malnutrition, sedentariness, and sarcopenia are risk factors amenable to intervention. The Asia-Pacific Frailty Management Guidelines recommend anabolic exercise and the optimisation of medications and nutrition. However, no study has evaluated this best practice intervention triad in aged care.

METHODS

The Frailty Reduction via the Implementation of Exercise, Nutrition, and Deprescribing (FRIEND) Trial (ANZCTR No.ACTRN12622000926730p) is a staged 6-month translational trial evaluating resident outcomes, staff/caregiver knowledge, and institutional implementation in a Townsville aged care facility. Residents received high-intensity resistance exercise and balance training and medication and nutrition optimisation co-implemented by investigators (exercise physiologist, geriatrician, pharmacist, and nutritionist) and facility staff. Staff and caregivers completed comprehensive education modules and training. We report the trial protocol and recruitment results.

RESULTS

29 residents (21 female, age: 88.6 ± 6.3 years) were recruited. At baseline, the residents were frail (frailty scale nursing home (FRAIL-NH); 6.3 ± 2.4/14), cognitively impaired (Montreal Cognitive Assessment; 13.8 ± 6.8/30), functionally impaired (Short Physical Performance Battery; 4.9 ± 3.1/12, 6 min walk distance; 222.2 ± 104.4 m), and were prescribed numerous medications (15.5 ± 5.9). Two residents died and one withdrew before the intervention's commencement. Thirty family members and 19 staff (carers, allied health assistants, nurse managers, registered nurses, lifestyle-leisure officers, kitchen/hospitality staff, and senior leadership) were recruited to receive frailty education modules.

CONCLUSIONS

The FRIEND trial is currently being implemented with results expected in mid-2024. This is the first trial to evaluate the implementation of the best practice frailty guidelines including anabolic exercise and medication/nutritional optimisation in residential aged care.

摘要

引言

老年护理机构中几乎所有成年人都很虚弱，这种状况会导致跌倒、认知能力下降、住院和死亡。多重用药、营养不良、久坐不动和肌肉减少症是可通过干预改善的风险因素。《亚太地区虚弱管理指南》推荐进行合成代谢运动以及优化药物和营养。然而，尚无研究评估老年护理中这种最佳实践干预三联法。

方法

通过实施运动、营养和减药来减轻虚弱（FRIEND）试验（澳大利亚和新西兰临床试验注册中心编号：ACTRN12622000926730p）是一项为期6个月的分阶段转化试验，评估汤斯维尔一家老年护理机构中居民的结局、工作人员/护理人员的知识水平以及机构实施情况。居民接受了高强度抗阻运动和平衡训练，以及由研究人员（运动生理学家、老年病学家、药剂师和营养师）和机构工作人员共同实施的药物和营养优化措施。工作人员和护理人员完成了综合教育模块和培训。我们报告试验方案和招募结果。

结果

招募了29名居民（21名女性，年龄：88.6±6.3岁）。基线时，居民身体虚弱（养老院虚弱量表（FRAIL-NH）；6.3±2.4/14）、认知受损（蒙特利尔认知评估；13.8±6.8/30）、功能受损（简短体能状况量表；4.9±3.1/12，6分钟步行距离；222.2±104.4米），并且正在服用多种药物（15.5±5.9）。两名居民在干预开始前死亡，一名退出。招募了30名家庭成员和19名工作人员（护理人员、专职医疗助理、护士经理、注册护士、生活方式与休闲专员、厨房/餐饮工作人员和高级管理人员）接受虚弱教育模块。