Feasibility of a Multidisciplinary Student-Led Program to Improve Frailty in Nursing Home Residents
NCT ID: NCT07182747
Last Updated: 2025-09-19
Study Results
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Basic Information
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NOT_YET_RECRUITING
NA
60 participants
INTERVENTIONAL
2025-10-01
2026-08-30
Brief Summary
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Currently, it is estimated that between 50% and 75% of older adults living in residential care facilities present with frailty. This clinical profile is often directly associated with multiple comorbidities (around 65-85% of this population suffer from several chronic conditions), emotional decline, polypharmacy, malnutrition and a high prevalence of functional and cognitive impairment. Consequently, two out of every three older adults will require long-term care in specialised centres during their lifetime. In this context, nursing homes represent a key setting not only for providing care, but also for the prevention, detection and management of conditions such as frailty. However, care in residential facilities continues to focus on addressing established problems, with low participation in activities with potential benefits and a high perception of loneliness. Therefore, interventions in these contexts aimed at improving frailty are both necessary and urgent, particularly those that integrate a biopsychosocial approach, promote autonomy and foster active ageing.
Several studies have demonstrated that multidisciplinary intervention programmes and multicomponent physical training are effective in preventing frailty and its consequences. Nevertheless, their widespread implementation is limited by several factors. On the one hand, there is a lack of scientific evidence on the cost-effectiveness of such interventions, and on the other, healthcare systems face budgetary constraints in a context of increasing demand for geriatric care. In the search for more effective interventions to improve frailty and other related variables in older adults residing in nursing homes, supervised multidisciplinary programmes, delivered by health sciences students and implemented by nursing students, may represent a viable alternative. In this regard, students of Physical Activity and Sport Sciences (CAFYD) possess the knowledge required to design physical activity plans adapted to the capacities and needs of older adults. However, given the nature of their care role, nurses provide added value: their continuous presence in the clinical setting enables them to establish a closer therapeutic bond with the patient, ensure thorough monitoring of their progress, and facilitate coordination between physicians and other healthcare team members. These features make nurses key agents in the implementation of comprehensive, person-centred interventions.
Despite the potential of implementing a multidisciplinary intervention programme through health sciences students to improve frailty in older adults living in residential facilities, to the best of our knowledge, no similar interventions exist. Therefore, it is necessary to assess the feasibility of implementing such a proposal prior to conducting a randomised controlled trial to confirm its clinical effectiveness, as this approach plays an important role in determining the most appropriate trial design. To this end, different feasibility study guidelines recommend including variables such as acceptance, adherence and dropout rates as key markers for successful implementation.
STUDY'S HYPOTHESIS The main hypothesis of the CUIDAFRAIL project is that a supervised multidisciplinary intervention programme carried out by nursing and Physical Activity and Sport Sciences students is feasible for improving frailty and other related variables in older adults living in residential care facilities.
AIM AND OBJECTIVES The aim of the CUIDAFRAIL project is to examine the short- term and medium-term effects of a nursing students' multidisciplinary intervention programme on frailty among older adults living in nursing homes.
The secondary objectives of this project are the following:
1. To examine the effects of the intervention on frailty, as well as other frailty-related variables, including physical fitness, functionality, fear of falling, emotional status, loneliness, social support and quality of life in older adults living in residential care facilities.
2. To examine the effects on physiological and clinical parameters associated with frailty.
3. To explore the perceptions and experiences of older adults participating in the programme upon completion.
4. To explore the perceptions and experiences of nursing and Physical Activity and Sport Sciences students upon completion of the programme.
STUDY DESIGN A feasibility study will be carried out. Participants will be randomly assigned to either an intervention group (IG) or a control group (CG).
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
DOUBLE
Study Groups
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Intervention group
Participants allocated to the 'intervention group' arm will receive the usual care offered by the Public Andalusian Healthcare Service in conjunction with a 12-week nursing students' intervention programme.
Nursing students' intervention programme
12-week intervention programme conducted by nursing students and students trained in Sciences of Physical Activity and Sport (CAFYD). Participants will receive weekly three sessions of 45-60 minutes. It will include physical exercise and occupational therapy sessions aimed at improving frailty and other related outcomes in the participating older adults through interdisciplinary collaboration and ongoing monitoring. Nursing students will implement personalised intervention programmes designed by a multidisciplinary team comprising CAFYD students, an occupational therapist, and nurses experienced in the care of older adults.
Standard care from Public Andalusian Health Service
They will receive the standard care provided by the Andalusian Health Service as part of its portfolio of services offered to older adults residing in institutions, as well as the standard care provided by the institutions in which they live. As part of these services, older adults receive support such as accommodation, laundry, health promotion activities, health monitoring, assistance with activities of daily living, individual, group, and community social care, as well as means of communication with the outside world. The action plans or protocols established in care processes for older adults living in nursing homes do not include externally delivered multidisciplinary intervention programmes.
Control group
Participants allocated to the 'control group' arm will only receive the usual care offered by the Public Andalusian Healthcare Service for 12 weeks.
Standard care from Public Andalusian Health Service
They will receive the standard care provided by the Andalusian Health Service as part of its portfolio of services offered to older adults residing in institutions, as well as the standard care provided by the institutions in which they live. As part of these services, older adults receive support such as accommodation, laundry, health promotion activities, health monitoring, assistance with activities of daily living, individual, group, and community social care, as well as means of communication with the outside world. The action plans or protocols established in care processes for older adults living in nursing homes do not include externally delivered multidisciplinary intervention programmes.
Interventions
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Nursing students' intervention programme
12-week intervention programme conducted by nursing students and students trained in Sciences of Physical Activity and Sport (CAFYD). Participants will receive weekly three sessions of 45-60 minutes. It will include physical exercise and occupational therapy sessions aimed at improving frailty and other related outcomes in the participating older adults through interdisciplinary collaboration and ongoing monitoring. Nursing students will implement personalised intervention programmes designed by a multidisciplinary team comprising CAFYD students, an occupational therapist, and nurses experienced in the care of older adults.
Standard care from Public Andalusian Health Service
They will receive the standard care provided by the Andalusian Health Service as part of its portfolio of services offered to older adults residing in institutions, as well as the standard care provided by the institutions in which they live. As part of these services, older adults receive support such as accommodation, laundry, health promotion activities, health monitoring, assistance with activities of daily living, individual, group, and community social care, as well as means of communication with the outside world. The action plans or protocols established in care processes for older adults living in nursing homes do not include externally delivered multidisciplinary intervention programmes.
Eligibility Criteria
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Inclusion Criteria
* Living in one of the institutions participating in the study.
* Signing the informed consent to participate in the study.
Exclusion Criteria
* Having moderate or severe cognitive impairment (Pfeiffer Test \>4); hypotension (systolic blood pressure \<90 mmHg, diastolic blood pressure \<60 mmHg), anemia (hemoglobin level \<9 g/dL), any acute metabolic disorder, uncontrolled hypertension (systolic blood pressure \>160 mmHg, diastolic blood pressure \>100 mmHg), uncontrolled arrhythmia, stable/unstable angina, uncontrolled chronic or metabolic disease, and advanced cerebrovascular or peripheral vascular disease
* Having undergone surgery within the last six weeks.
65 Years
ALL
No
Sponsors
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Universidad de Almeria
OTHER
Responsible Party
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Jose Manuel Hernandez Padilla
Professor (Full)
Locations
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Universidad de Almería
Almería, Spain, Spain
Countries
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Central Contacts
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Facility Contacts
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References
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Teresi JA, Yu X, Stewart AL, Hays RD. Guidelines for Designing and Evaluating Feasibility Pilot Studies. Med Care. 2022 Jan 1;60(1):95-103. doi: 10.1097/MLR.0000000000001664.
Lockwood EB, Schober M. Factors Influencing the impact of nurse practitioners' clinical autonomy: a self determining perspective. Int Nurs Rev. 2024 Jun;71(2):375-395. doi: 10.1111/inr.12948. Epub 2024 Apr 23.
Saunders R, Seaman K, Graham R, Christiansen A. The effect of volunteers' care and support on the health outcomes of older adults in acute care: A systematic scoping review. J Clin Nurs. 2019 Dec;28(23-24):4236-4249. doi: 10.1111/jocn.15041. Epub 2019 Sep 30.
de Sandes-Guimaraes LV, Dos Santos PC, Alves CPGP, Cervato CJ, Silva APA, Leao ER. The effect of volunteer-led activities on the quality of life of volunteers, residents, and employees of a long-term care institution: a cohort study. BMC Geriatr. 2023 Mar 20;23(1):151. doi: 10.1186/s12877-023-03898-y.
Jadczak AD, Makwana N, Luscombe-Marsh N, Visvanathan R, Schultz TJ. Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic reviews. JBI Database System Rev Implement Rep. 2018 Mar;16(3):752-775. doi: 10.11124/JBISRIR-2017-003551.
Garcia-Nogueras I, Aranda-Reneo I, Pena-Longobardo LM, Oliva-Moreno J, Abizanda P. Use of Health Resources and Healthcare Costs associated with Frailty: The FRADEA Study. J Nutr Health Aging. 2017;21(2):207-214. doi: 10.1007/s12603-016-0727-9.
Veronese N, Custodero C, Cella A, Demurtas J, Zora S, Maggi S, Barbagallo M, Sabba C, Ferrucci L, Pilotto A. Prevalence of multidimensional frailty and pre-frailty in older people in different settings: A systematic review and meta-analysis. Ageing Res Rev. 2021 Dec;72:101498. doi: 10.1016/j.arr.2021.101498. Epub 2021 Oct 23.
Rivas-Ruiz F, Machon M, Contreras-Fernandez E, Vrotsou K, Padilla-Ruiz M, Diez Ruiz AI, de Mesa Berenguer Y, Vergara I; Group GIFEA. Prevalence of frailty among community-dwelling elderly persons in Spain and factors associated with it. Eur J Gen Pract. 2019 Oct;25(4):190-196. doi: 10.1080/13814788.2019.1635113. Epub 2019 Oct 22.
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Gutierrez-Valencia M, Izquierdo M, Cesari M, Casas-Herrero A, Inzitari M, Martinez-Velilla N. The relationship between frailty and polypharmacy in older people: A systematic review. Br J Clin Pharmacol. 2018 Jul;84(7):1432-1444. doi: 10.1111/bcp.13590. Epub 2018 May 3.
Espinoza SE, Quiben M, Hazuda HP. Distinguishing Comorbidity, Disability, and Frailty. Curr Geriatr Rep. 2018 Dec;7(4):201-209. doi: 10.1007/s13670-018-0254-0. Epub 2018 Sep 19.
Milte R, Petersen J, Boylan J, Henwood T, Hunter S, Lange B, Lawless M, Torode S, Lewis LK. Prevalence and determinants of physical frailty among people living in residential aged care facilities: a large-scale retrospective audit. BMC Geriatr. 2022 May 14;22(1):424. doi: 10.1186/s12877-022-03101-8.
Kojima G. Frailty as a predictor of disabilities among community-dwelling older people: a systematic review and meta-analysis. Disabil Rehabil. 2017 Sep;39(19):1897-1908. doi: 10.1080/09638288.2016.1212282. Epub 2016 Aug 24.
Cesari M, Marzetti E, Thiem U, Perez-Zepeda MU, Abellan Van Kan G, Landi F, Petrovic M, Cherubini A, Bernabei R. The geriatric management of frailty as paradigm of "The end of the disease era". Eur J Intern Med. 2016 Jun;31:11-4. doi: 10.1016/j.ejim.2016.03.005. Epub 2016 Mar 18.
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Hladek MD, Gill J, Bandeen-Roche K, Walston J, Allen J, Hinkle JL, Lorig K, Szanton SL. High coping self-efficacy associated with lower odds of pre-frailty/frailty in older adults with chronic disease. Aging Ment Health. 2020 Dec;24(12):1956-1962. doi: 10.1080/13607863.2019.1639136. Epub 2019 Jul 10.
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Cai Y, Han Z, Cheng H, Li H, Wang K, Chen J, Liu ZX, Xie Y, Lin Y, Zhou S, Wang S, Zhou X, Jin S. The impact of ageing mechanisms on musculoskeletal system diseases in the elderly. Front Immunol. 2024 May 7;15:1405621. doi: 10.3389/fimmu.2024.1405621. eCollection 2024.
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Huesa Andrade M, Calvo-Gallego JL, Pedregal Gonzalez MA, Bohorquez Colombo P. [Differences between institutionalized patients and those included in a home care program in Seville]. Aten Primaria. 2020 Aug-Sep;52(7):488-495. doi: 10.1016/j.aprim.2019.10.002. Epub 2020 Feb 17. Spanish.
Other Identifiers
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A01037772
Identifier Type: -
Identifier Source: org_study_id
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