Physical Activity Clinical Trial
Official title:
Frailty Intervention Trial in End-Stage Patients on Dialysis: A Feasibility Study
The proposed investigation for this study aims to; 1) understand the prevalence and outcomes
associated with frailty among haemodialysis patients; 2) ascertain the best frailty
assessment tool for haemodialysis patients, and; 3) design a clinical study to explore the
feasibility of facilitating, recruiting and executing a multi-disciplinary clinical and
psychological intervention to improve frailty status among haemodialysis patients.
Work package 1: Firstly, there is a need to understand the prevalence and spectrum of frailty
in a UK haemodialysis cohort and what impact frailty has for haemodialysis patients. To
investigate this, the investigators will approach every patient on haemodialysis within the
local catchment of haemodialysis units and, after informed consent, clinically phenotype
their frailty status (pre- and post-haemodialysis for calculation of variability). The
frailty phenotyping will encompass a number of frailty assessments (including the Edmonton
Frail Scale, Clinical Frailty Scale from Rookwood score and Fried Frailty scale) to identify
the ideal frailty assessment tool. All patients in this observational cohort study will be
prospectively monitored for clinical/biochemical outcomes using an informatics-based approach
for up to 60 months.
Work package 2: Building upon the work conducted in work package 1, work package 2 will aim
to recruit 50 patients clinically phenotyped with pre-frailty from work package 1 into a
feasibility study exploring a multi-disciplinary intervention to improve frailty status.
Eligible patients, after informed consent, will be randomised into active or passive
intervention. The active intervention will involve a dietitian and physiotherapist who have
been trained and accredited with cognitive behavior intervention, utilising established
behavioral intervention frameworks, to deliver a multi-disciplinary clinical intervention
targeting multiple components of frailty.
The FITNESS project will therefore answer some important unanswered questions regarding
frailty among the haemodialysis population and help in the design of a large
multi-disciplinary intervention study if deemed feasible.
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