A Tailored Discharge Program Improves Frailty and Mood in Patients Undergoing Usual Rehabilitative Care: A Randomized Controlled Trial

Meyer, Anna Maria; Bartram, Malte P.; Antczak, Philipp; Becker, Ingrid; Benzing, Thomas; Polidori, Maria Cristina

doi:10.1016/j.jamda.2022.09.003

Cited by 9 publications

(9 citation statements)

References 49 publications

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“…Limitations of this analysis: One limitation was the relatively small sample size of this study population, with 97 patients included. However, the patient population was highly phenotypized [12], and several of the observations confirm what is already reported in the literature. Another limitation is the relatively short follow-up period, i.e., 6 months, which was predetermined as per the original RCT protocol.…”

Section: Discussionsupporting

confidence: 88%

“…Study Design and Patients: To achieve the above-described aim, data obtained from older multimorbid inpatients included in an RCT investigating the effects of a tailored individualized discharge program (TIDP) compared with usual rehabilitative care [ 12 ] in an acute clinical ward co-led by geriatricians and internists were used. As a recently established innovative ward of the large metropolitan University Hospital of Cologne designed to cover the needs of the older population of multimorbid patients requiring potentially disabling disease-centered high-performance medicine [ 12 ], patients undergo early complex geriatric rehabilitation (ECGR), and the ward is co-led by internists and geriatricians equally responsible for clinical decision making [ 12 ]. Patients 60 years old or older were included if they were admitted due to acute disease or relapse of a chronic condition, multimorbid (with synchronous presence of two or more chronic conditions that require long-term treatment [ 13 ]), and suffering from at least two geriatric syndromes requiring typical rehabilitative care.…”

Section: Methodsmentioning

confidence: 99%

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Prognostic Features of Sarcopenia in Older Hospitalized Patients: A 6-Month Follow-Up Study

Ferring,

Mück,

Stegemann

et al. 2024

JCM

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Background: Sarcopenia is associated with adverse health outcomes. Understanding the association between sarcopenia, multidimensional frailty, and prognosis is essential for improving patient care. The aim of this study was to assess the prevalence and prognostic signature of sarcopenia in an acute hospital setting co-led by internists and geriatricians. Methods: Sarcopenia was assessed by applying the European Working Group on Sarcopenia in Older People (EWGSOP2) algorithm, including the SARC-F score, handgrip strength, bioelectrical impedance analysis (BIA), and Timed Up and Go (TUG) test, to 97 older multimorbid inpatients (76.5 ± 6.8 years, 55% women). The patients underwent a Comprehensive Geriatric Assessment (CGA) including an evaluation of Geriatric Syndromes (GSs) and Resources (GR) and prognosis calculation using the CGA-based Multidimensional Prognostic Index (MPI), European Quality of life—5 Dimensions (EQ-5D-5L) scale, Rosenberg Self-Esteem Scale (RSES), and Geriatric Depression Scale (GDS). Information on survival and rehospitalizations was collected 1, 3, and 6 months after discharge. Results: Sarcopenia was present in 63% (95% CI: 54–72%) of patients and categorized as probable (31%), confirmed (13%), and severe sarcopenia (18%). Sarcopenic patients showed significantly higher median MPI-values (p < 0.001), more GSs (p = 0.033), fewer GR (p = 0.003), lower EQ-5D-5L scores (p < 0.001), and lower RSES scores (p = 0.025) than non-sarcopenic patients. Six months after discharge, being sarcopenic at baseline was predictive of falls (p = 0.027) and quality of life (p = 0.043), independent of age, gender, and MPI. Conclusions: Sarcopenia is highly prevalent in older hospitalized multimorbid patients and is associated with poorer prognosis, mood, and quality of life up to 6 months after discharge, independent of age, sex, and MPI as surrogate markers of biological age.

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Section: Discussionsupporting

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Prognostic Features of Sarcopenia in Older Hospitalized Patients: A 6-Month Follow-Up Study

Ferring,

Mück,

Stegemann

et al. 2024

JCM

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“…Leider mangelt es dazu an Evidenz aus systematischen Übersichtsarbeiten und Metaanalysen. Einzelne Studien haben aber gezeigt, dass Maßnahmen in der Primärversorgung, die körperliche Aktivität und Ernährung fördern, das unerwünschte Fortschreiten von Pre-Frailty zu Frailty verhindern können [7,8,9,10,11,12,13] (▶ Tab. 1).…”

Section: Maßnahmen In Der Primärversorgungunclassified

“…In der Sekundärprävention finden jedoch nicht nur physische Interventionen statt. Denn auch hier haben verschiedene Studien positive Effekte einer Multidomänen-Intervention auf den Progress der Frailty sowie die Lebensqualität gezeigt [12]. Ein Beispiel dafür ist ein individuelles, intersektoriales Entlassmanagement älterer pre-frailer und frailer Patienten nach der Hospitalisierung aufgrund einer akuten Erkrankung.…”

Section: Multidomänen-interventionenunclassified

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Frailty: Prävention

Polidori,

Sieber

2023

Dtsch Med Wochenschr

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Long-Term Effects of Transtheoretical Model-Based Lifestyle Intervention on Self-efficacy and Self-management in Patients with Type 2 Diabetes — Randomised Controlled Trial

Dunkel,

von Storch,

Hochheim

et al. 2024

Int.J. Behav. Med.

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Background Self-efficacy and self-management are fundamental factors for successful treatment of type 2 diabetes, but long-term studies are rare. The aim of the present study is to investigate whether the effects achieved in the context of a lifestyle intervention based on the transtheoretical model can be maintained by the patients in the long term. Method A two-arm randomised controlled trial examined whether long-term effects of self-efficacy, self-management, and HbA1c can be achieved by a lifestyle intervention of 12 months and persisted beyond the intervention. During the intervention, the intervention group (n = 86, mean age 59.7 years) was supported by a telephone coach and telemedical devices, while the control group (n = 65, mean age 58.8 years) received regular care. In the year after intervention, both groups received standard care. Results The intervention group achieved significantly better self-management after 12 and 24 months (12M, 1.11 (0.81; 1.41) p < .000; 24M, 0.52 (0.19; 0.85) p = .002) as well as self-efficacy (12M, 1.18 (0.83; 1.52) p < .000; 24M, 0.76 (0.39; 1.13) p < .000) and HbA1c than the control group. Conclusion TTM-based lifestyle interventions show a long-term effect beyond the duration of the intervention in most areas, and behavioural changes can be sustained by patients.

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A Tailored Discharge Program Improves Frailty and Mood in Patients Undergoing Usual Rehabilitative Care: A Randomized Controlled Trial

Cited by 9 publications

References 49 publications

Prognostic Features of Sarcopenia in Older Hospitalized Patients: A 6-Month Follow-Up Study

Prognostic Features of Sarcopenia in Older Hospitalized Patients: A 6-Month Follow-Up Study

Frailty: Prävention

Long-Term Effects of Transtheoretical Model-Based Lifestyle Intervention on Self-efficacy and Self-management in Patients with Type 2 Diabetes — Randomised Controlled Trial

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