Preventing functional decline in acutely hospitalized older adults – effect and process evaluation of a transitional care intervention (PREV FUNC study)

Older adults who are hospitalized because of acute medical illness often experience worsening of physical function, and the transition from hospital to home may pose an additional risk.

Even relatively small amounts of exercise might mitigate the risk of physical impairment, emphasizing the importance of identifying efficient and easy-to-use exercise interventions for older hospitalized people.In this project, we aim to 1) to examine if a transitional care program consisting of walking and sit-to-stand exercises performed during acute hospitalization and as self-training at home has effect over usual care concerning physical function in people aged 75-years and older, 2) perform a process evaluation during the different phases of the project, and, 3) translate the knowledge into clinical practice.We will conduct a randomized controlled trial.

Participants aged 75-years and older will be included consecutively from geriatric medical wards of two hospitals in Region Stockholm. The intervention starts at the hospital and continues at home six weeks after discharge. The primary outcome is the score on the Short Physical Performance Battery (SPPB) at three months after discharge.

Secondary outcomes are SBBP at hospital discharge, and the number of hospital readmissions six months after discharge.The project will include a pilot study to explore the feasibility and optimize the research design, and a process evaluation to assess the quantity and quality of what was delivered and the role of context.

In the final phase of the project, we will provide a description of the changes needed to translate the intervention into different settings, which will be helpful for further implementation.Most previous exercise intervention studies in older adults were performed either at the hospital or at home.

Thus, the proposed transitional care project may provide a novel strategy to maintain or improve physical function in this frail and vulnerable group.