A rehabilitation intervention to improve recovery after an episode of delirium in adults over 65 years (RecoverED): study protocol for a multi-centre, single-arm feasibility study.

Autor: Allan L; University of Exeter Medical School, University of Exeter, Exeter, UK., O'Connell A; University of Exeter Medical School, University of Exeter, Exeter, UK., Raghuraman S; University of Exeter Medical School, University of Exeter, Exeter, UK., Bingham A; University of Exeter Medical School, University of Exeter, Exeter, UK., Laverick A; University of Exeter Medical School, University of Exeter, Exeter, UK., Chandler K; University of Exeter Medical School, University of Exeter, Exeter, UK., Connors J; University of Exeter Medical School, University of Exeter, Exeter, UK., Jones B; University of Exeter Medical School, University of Exeter, Exeter, UK., Um J; University of Exeter Medical School, University of Exeter, Exeter, UK. j.um@exeter.ac.uk., Morgan-Trimmer S; University of Exeter Medical School, University of Exeter, Exeter, UK., Harwood R; School of Health Sciences, University of Nottingham, Nottingham, UK.; Nottingham University Hospitals NHS Trust, Nottingham, UK., Goodwin VA; Department of Ageing and Rehabilitation, University of Exeter, Exeter, UK., Ukoumunne OC; Department of Health and Community Sciences, Faculty of Health and Life Sciences, National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) South West Peninsula (PenARC), University of Exeter, Exeter, EX1 2LU, UK., Hawton A; Health Economics Group, University of Exeter Medical School, Exeter, UK., Anderson R; Exeter HS&DR Evidence Synthesis Centre, Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK., Jackson T; Institute of Inflammation and Ageing, University of Birmingham Research Laboratories, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham, B15 2WD, UK., MacLullich AMJ; Scottish Hip Fracture Audit (SHFA), NHS National Services Scotland, Edinburgh, UK.; Ageing and Health Group, Usher Institute, University of Edinburgh, Edinburgh, UK., Richardson S; AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK., Davis D; MRC Unit for Lifelong Health and Ageing at UCL, London, WC1E 7HB, UK., Collier L; Faculty of Health and Well-Being, University of Winchester, Winchester, SO22 4NR, UK., Strain WD; Diabetes and Vascular Medicine Research Centre, Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Exeter, EX2 5AX, UK., Litherland R; Innovations in Dementia, Exeter, UK., Glasby J; School of Social Policy, University of Birmingham, Birmingham, UK., Clare L; University of Exeter Medical School, University of Exeter, Exeter, UK.
Jazyk: angličtina
Zdroj: Pilot and feasibility studies [Pilot Feasibility Stud] 2023 Sep 15; Vol. 9 (1), pp. 162. Date of Electronic Publication: 2023 Sep 15.
DOI: 10.1186/s40814-023-01387-y
Abstrakt: Background: Delirium affects over 20% of all hospitalised older adults. Delirium is associated with a number of adverse outcomes following hospital admission including cognitive decline, anxiety and depression, increased mortality and care needs. Previous research has addressed prevention of delirium in hospitals and care homes, and there are guidelines on short-term treatment of delirium during admission. However, no studies have addressed the problem of longer-term recovery after delirium and it is currently unknown whether interventions to improve recovery after delirium are effective and cost-effective. The primary objective of this feasibility study is to test a new, theory-informed rehabilitation intervention (RecoverED) in older adults delivered following a hospital admission complicated by delirium to determine whether (a) the intervention is acceptable to individuals with delirium and (b) a definitive trial and parallel economic evaluation of the intervention are feasible.
Methods: The study is a multi-centre, single-arm feasibility study of a rehabilitation intervention with an embedded process evaluation. Sixty participants with delirium (aged > 65 years old) and carer pairs will be recruited from six NHS acute hospitals across the UK. All pairs will be offered the intervention, with follow-up assessments conducted at 3 months and 6 months post-discharge home. The intervention will be delivered in participants' own homes by therapists and rehabilitation support workers for up to 10 intervention sessions over 12 weeks. The intervention will be tailored to individual needs, and the chosen intervention plan and goals will be discussed and agreed with participants and carers. Quantitative data on reach, retention, fidelity and dose will be collected and summarised using descriptive statistics. The feasibility outcomes that will be used to determine whether the study meets the criteria for progression to a definitive randomised controlled trial (RCT) include recruitment, delivery of the intervention, retention, data collection and acceptability of outcome measures. Acceptability of the intervention will be assessed using in-depth, semi-structured qualitative interviews with participants and healthcare professionals.
Discussion: Findings will inform the design of a pragmatic multi-centre RCT of the effectiveness and cost-effectiveness of the RecoverED intervention for helping the longer-term recovery of people with delirium compared to usual care.
Trial Registration: The feasibility study was registered: ISRCTN15676570.
(© 2023. BioMed Central Ltd., part of Springer Nature.)
Databáze: MEDLINE
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