Evidence map›Paper›PMID 35761212›Full record

ArticleBMC geriatrics2022

Frailty in older people: Rehabilitation Treatment Research Examining Separate Settings (FORTRESS): protocol for a hybrid type II stepped wedge, cluster, randomised trial.

Heather Block, Alexandra Annesley, Keri Lockwood, Linda Xu, Ian D Cameron, Kate Laver, Maria Crotty, Catherine Sherrington, Annette Kifley, Kirsten Howard and 3 more

Open access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC geriatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 1 country.

Heather BlockRehabilitation, Palliative and Aged Care Division, Southern Adelaide Local Health Network, Adelaide, Australia. heather.block@sa.gov.au.ORCID 0000-0003-2632-8437
Alexandra AnnesleyRehabilitation and Aged Care Services, Northern Sydney Local Health District, Sydney, Australia.
Keri LockwoodFaculty of Medicine and Health, University of Sydney, Sydney, Australia.
Linda XuRehabilitation and Aged Care Services, Northern Sydney Local Health District, Sydney, Australia.
Ian D CameronRehabilitation and Aged Care Services, Northern Sydney Local Health District, Sydney, Australia.
Kate LaverFlinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Maria CrottyRehabilitation, Palliative and Aged Care Division, Southern Adelaide Local Health Network, Adelaide, Australia.
Catherine SherringtonFaculty of Medicine and Health, University of Sydney, Sydney, Australia.
Annette KifleyJohn Walsh Centre for Rehabilitation Research, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Kirsten HowardThe Menzies Centre for Health Policy and Economics, School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Dimity PondSchool of Medicine and Public Health, University of Newcastle, Newcastle, Australia.
Tuan A NguyenNational Ageing Research Institute, Melbourne, Australia.
Susan E KurrleRehabilitation and Aged Care Services, Northern Sydney Local Health District, Sydney, Australia.
The University of Sydney · AUFlinders University · AUNorthern Sydney Local Health District · AUUniversity of Newcastle Australia · AUUniversity of South Australia · AUWomen's and Children's Health Network · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFrailty in older people is associated with increased risk of falls, longer length of stay in hospital, increased risk of institutionalisation and death. Frailty can be measured using validated tools. Multi-component frailty interventions are recommended in clinical practice guidelines but are not routinely implemented in clinical practice.

methodsThe Frailty in Older people: Rehabilitation, Treatment, Research Examining Separate Settings (FORTRESS) trial is a multisite, hybrid type II, stepped wedge, cluster, randomised trial with blinded assessment and intention-to-treat analysis being conducted in Australia. The study aims to determine the effectiveness and cost-effectiveness of an embedded individualised multicomponent frailty intervention (commencing in hospital and continuing in the community) on readmissions, frailty and quality of life when compared with usual care. Frail older people admitted to study wards with no significant cognitive impairment, who are expected to return home after discharge, will be eligible to participate. Participants will receive extra sessions of physiotherapy, pharmacy, and dietetics during their admission. A Community Implementation Facilitator will coordinate implementation of the frailty management strategies and primary network liaison. The primary outcome is number of days of non-elective hospital readmissions during 12 month follow-up period. Secondary outcomes include frailty status measured using the FRAIL scale; quality of life measured using the EQ-5D-5L; and time-to-event for readmission and readmission rates. The total cost of delivering the intervention will be assessed, and cost-effectiveness analyses will be conducted. Economic evaluation will include analyses for health outcomes measured in terms of the main clinical outcomes. Implementation outcomes will be collected as part of a process evaluation. Recruitment commenced in 2020 and we are aiming to recruit 732 participants over the three-year duration of the study. DISCUSSION: This study will reveal whether intervening with frail older people to address factors contributing to frailty can reduce hospital readmissions and improve frailty status and quality of life. If the FORTRESS intervention provides a clinically significant and cost-effective result, it will demonstrate an improved approach to treating frail patients, both in hospital and when they return home.

trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12620000760976p . ANZCTR registered 24 July 2020.

Indexed as

FrailtyAccidental FallsAgedAustraliaHospitalizationHumansQuality of LifeRandomized Controlled Trials as TopicAgedExerciseFrailtyHospitalImplementationNutritionOlder peoplePrimary careTransition

Identifiers

PMID35761212
PMCPMC9235164
OpenAlexW4283590335

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.