The post-hospital program of self-managed diet and exercise saw a drop in readmission rates.
Frailty and readmissions have been wound back in a self-managed care pilot at Flinders University hospital.
The randomised control trial showed “encouraging results” and a reduction of frailty for patients who undertook a three-month long program of self-managed diet and exercise. The program integrated telehealth and clinician visits from a multidisciplinary team.
Compared to the control group, study participants had significantly greater reduction of frailty at three and/or six months measured against the Edmonton Frail Scale, Short Physical Performance Battery, cognitive impairment, handgrip strength, and Geriatric Depression Scale.
Dr Chad Han, lead author of the study at Flinders University, said that the study provides proof of acceptability and adherence to a patient self-managed exercise-nutrition program that may reverse or slow down the progression of pre-frailty and frailty.
“The results may provide guidance to clinicians and researchers looking to develop or implement self-managed exercise-nutrition program for this cohort,” he said.
Dr Han told The Medical Republic that nearly two-thirds of patients admitted to Flinders Medical Centre were classified as either pre-frail or frail.
“Pre-frailty and frailty in older adults are associated with poor health outcomes and increased healthcare costs – and these worsen during hospitalisation,” says Dr Han.
“We can see a trend that more people in the intervention group are not being readmitted to hospital, compared to the control group which are those receiving standard care,” he said.
Frailty is a clinical condition characterised by decline in function, and is often associated with slowness, low physical activity and weight loss.
Dr Han said there was high program acceptance and adherence by patients. He is currently finalising a paper on what enabled such success.
“We’ll find out what actually helps people to stick to their nutrition and exercise intervention. How do people actually do it? What are the enablers and barriers?” he said.
The trial adapted a self-management model of care, created at Flinders University for managing chronic conditions like diabetes. Dr Han credits the high adherence to this model that keeps patients motivated by reminding them why they’re doing the program.
“Everyone has different goals in their life. At this stage of life, for older adults, their goal might be just to get up from the toilet seat independently. That’s their motivation. So, we can’t use a one-size-fits-all intervention. That’s the great part about the chronic condition management model – it really individualises everything for them,” he said.
The program was developed by a group of researchers at Flinders University that involved dieticians Professor Michelle Miller, Dr Alison Yaxley and Dr Chad Han, physiotherapist Dr Claire Baldwin, and physician Associate Professor Yogesh Sharma.
Flinders Medical Centre is the largest hospital in the Southern Adelaide Local Health Network (SALHN). It provides a 24/7 emergency department and is co-located with the Flinders University School of Medicine and Flinders Private Hospital.
