JMIR Publications

ABSTRACT

Background:

Interventions to improve the nutritional status of older adults and the integration of formal and family care systems are critical research areas to improve the independence and health of ageing communities; and are particularly relevant in the rehabilitation setting.

Objective:

In malnourished older adults, does the FREER intervention during and post-rehabilitation improve nutritional status, physical function, quality of life, service satisfaction, and hospital and aged care admission rates up to 3-months post-discharge, compared with usual care? Secondary outcomes evaluated include family carer burden, carer services satisfaction, and patient and carer experiences. This pilot study will also evaluate feasibility and intervention fidelity to inform a larger randomised controlled trial.

Methods:

This is the protocol for a mixed-methods two-arm historically-controlled prospective pilot intervention study. The historical control group has 30 participants, and the pilot intervention group aims to recruit 30 patient-carer pairs. The FREER intervention delivers nutrition counselling during rehabilitation, 3-months of post-discharge telehealth follow-up, and provides supportive resources using a novel model of patient-centred and carer-centred nutrition care. The primary outcome is nutritional status measured by the Scored Patient-Generated Subjective Global Assessment score. Qualitative outcomes such as experiences and perceptions of value will be measured using semi-structured interviews followed by thematic analysis. The process evaluation addresses intervention fidelity and feasibility.

Results:

Recruitment commenced on the 4th July 2018 and is ongoing, with eight patient-carer pairs recruited at the time of manuscript submission.

Conclusions:

This research will inform a larger randomised controlled trial, with potential for translation to health service policies and new models of dietetic care to support the optimisation of nutritional status across a continuum of nutrition care from rehabilitation to home. Clinical Trial: Australian New Zealand Clinical Trials Registry (Trial ID: ACTRN12618000338268).