The Frailty Reduction via Implementation of Exercise, Nutrition and Deprescribing (FRIEND) Trial: Study Protocol and Recruitment Results

Inskip, Michael, Almendrales Rangel, Carolina, Njoku, Maria Chidiamara Augustina, Barnett, Fiona, Shih, Isabel, O'Neill, Leonie, Fiatarone Singh, Maria A., and Valenzuela Arteaga, Trinidad (2024) The Frailty Reduction via Implementation of Exercise, Nutrition and Deprescribing (FRIEND) Trial: Study Protocol and Recruitment Results. Methods and Protocols, 7 (2).

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Introduction: Virtually all adults in aged care facilities are frail, a condition which contributes to falls, cognitive decline, hospitalisation, and mortality. Polypharmacy, malnutrition, sedentariness, and sarcopenia are risk factors amenable to intervention. The Asia–Pacific Frailty Management Guidelines recommend anabolic exercise and the optimisation of medications and nutrition. However, no study has evaluated this best practice intervention triad in aged care.

Methods: The Frailty Reduction via the Implementation of Exercise, Nutrition, and Deprescribing (FRIEND) Trial (ANZCTR No.ACTRN12622000926730p) is a staged 6-month translational trial evaluating resident outcomes, staff/caregiver knowledge, and institutional implementation in a Townsville aged care facility. Residents received high-intensity resistance exercise and balance training and medication and nutrition optimisation co-implemented by investigators (exercise physiologist, geriatrician, pharmacist, and nutritionist) and facility staff. Staff and caregivers completed comprehensive education modules and training. We report the trial protocol and recruitment results.

Results: 29 residents (21 female, age: 88.6 ± 6.3 years) were recruited. At baseline, the residents were frail (frailty scale nursing home (FRAIL-NH); 6.3 ± 2.4/14), cognitively impaired (Montreal Cognitive Assessment; 13.8 ± 6.8/30), functionally impaired (Short Physical Performance Battery; 4.9 ± 3.1/12, 6 min walk distance; 222.2 ± 104.4 m), and were prescribed numerous medications (15.5 ± 5.9). Two residents died and one withdrew before the intervention’s commencement. Thirty family members and 19 staff (carers, allied health assistants, nurse managers, registered nurses, lifestyle–leisure officers, kitchen/hospitality staff, and senior leadership) were recruited to receive frailty education modules.

Conclusions: The FRIEND trial is currently being implemented with results expected in mid-2024. This is the first trial to evaluate the implementation of the best practice frailty guidelines including anabolic exercise and medication/nutritional optimisation in residential aged care.

Item ID: 82498
Item Type: Article (Scholarly Work)
ISSN: 2409-9279
Keywords: frailty; gerontology; aged care; exercise; nutrition; medication optimization.
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Copyright Information: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (
Funders: Dementia Collaborative Research Centre (DCRC): Carers and Consumers, James Cook University (JCU)
Projects and Grants: DCRC Implementing Research Evidence into Practice Grant, JCU Chiropractic Research Fund
Date Deposited: 02 Apr 2024 02:24
FoR Codes: 42 HEALTH SCIENCES > 4207 Sports science and exercise > 420702 Exercise physiology @ 50%
42 HEALTH SCIENCES > 4203 Health services and systems > 420301 Aged health care @ 50%
SEO Codes: 20 HEALTH > 2003 Provision of health and support services > 200301 Allied health therapies (excl. mental health services) @ 33%
20 HEALTH > 2005 Specific population health (excl. Indigenous health) > 200502 Health related to ageing @ 34%
20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 33%
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