{
  "abstract": "Objectives To test a theory-informed, person-centred rehabilitation intervention for older adults following a hospital admission complicated by delirium, developed in line with the Medical Research Council framework for complex interventions, 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.Design Multicentre, single-arm feasibility study.Participants 19 patient (aged >65 years old) and carer pairs were recruited from six National Health Service acute hospitals across the UK.Intervention Home-based rehabilitation programme designed to support recovery after hospital discharge, addressing cognitive, physical, physiological and psychosocial needs. Delivered by a trained team of occupational therapists, physiotherapists and rehabilitation support workers, the intervention included a comprehensive home assessment, collaborative goal setting, up to 10 personalised sessions over 12 weeks and the use of a recovery record to guide progress, education and psychosocial support.Outcome measures Examined aspects of feasibility including eligibility, recruitment, data collection, attrition, acceptability of the rehabilitation intervention and potential to calculate cost-effectiveness.Results In total, 419 patients were identified as having delirium and 36 met the full eligibility. 19 patient and carer pairs agreed to participate in the study (consent rate 53%; 95% CI 35% to 70%) with 13 participants going on to start the intervention (68%; 95% CI 43% to 87%) and 10 participants completing final follow-up (53%; 95% CI 29% to 76%). Baseline assessments were conducted either during hospitalisation or postdischarge, with initial assessments occurring a mean of 18 days (SD=13.0) postdischarge, and 77% completed within 14 days. Participants completed a mean of eight sessions (SD=2.9). 19 participants completed the primary outcome at baseline, while 10 participants completed it at 6-month follow-up. The economic evaluation indicated a total cost of £1249.29 per participant, covering assessments, intervention sessions and training costs.Conclusions The intervention showed feasibility among older adults recovering from delirium, as evidenced by the trial processes for participants who entered the study. However, recruitment challenges indicate a need for better strategies and further research through a definitive randomised controlled trial to demonstrate the effectiveness and cost-effectiveness of the intervention.Trial registration number ISRCTN15676570",
  "authors": [
    {
      "affiliations": [
        "Medical School, University of Exeter Faculty of Health and Life Sciences, Exeter, UK",
        "NIHR Applied Research Collaboration South West Peninsula, University of Exeter, Exeter, UK"
      ],
      "name": "Louise Allan"
    },
    {
      "affiliations": [
        "Medical School, University of Exeter Faculty of Health and Life Sciences, Exeter, UK"
      ],
      "name": "Jinpil Um"
    },
    {
      "affiliations": [
        "Our Future Health, Manchester, UK"
      ],
      "name": "Abby O’Connell"
    },
    {
      "affiliations": [
        "Medical School, University of Exeter Faculty of Health and Life Sciences, Exeter, UK"
      ],
      "name": "Shruti Raghuraman"
    },
    {
      "affiliations": [
        "Medical School, University of Exeter Faculty of Health and Life Sciences, Exeter, UK"
      ],
      "name": "Alison Bingham"
    },
    {
      "affiliations": [
        "Medical School, University of Exeter Faculty of Health and Life Sciences, Exeter, UK"
      ],
      "name": "Abigail Laverick"
    },
    {
      "affiliations": [
        "Medical School, University of Exeter Faculty of Health and Life Sciences, Exeter, UK"
      ],
      "name": "Kirstie Chandler"
    },
    {
      "affiliations": [
        "Exeter Clinical Trials Unit, University of Exeter, Exeter, UK"
      ],
      "name": "James Connors"
    },
    {
      "affiliations": [
        "Medical School, University of Exeter Faculty of Health and Life Sciences, Exeter, UK"
      ],
      "name": "Aseel Mahmoud"
    },
    {
      "affiliations": [
        "Medical School, University of Exeter Faculty of Health and Life Sciences, Exeter, UK",
        "NIHR Applied Research Collaboration South West Peninsula, University of Exeter, Exeter, UK"
      ],
      "name": "Annie Hawton"
    },
    {
      "affiliations": [
        "Medical School, University of Exeter Faculty of Health and Life Sciences, Exeter, UK"
      ],
      "name": "Elizabeth Goodwin"
    },
    {
      "affiliations": [
        "Medical School, University of Exeter Faculty of Health and Life Sciences, Exeter, UK"
      ],
      "name": "Sarah Morgan-Trimmer"
    },
    {
      "affiliations": [
        "Medical School, University of Exeter Faculty of Health and Life Sciences, Exeter, UK",
        "NIHR Applied Research Collaboration South West Peninsula, University of Exeter, Exeter, UK"
      ],
      "name": "Victoria A Goodwin"
    },
    {
      "affiliations": [
        "NIHR Applied Research Collaboration South West Peninsula, University of Exeter, Exeter, UK"
      ],
      "name": "Obioha C Ukoumunne"
    },
    {
      "affiliations": [
        "Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK"
      ],
      "name": "Thomas A Jackson"
    },
    {
      "affiliations": [
        "AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK"
      ],
      "name": "Sarah J Richardson"
    },
    {
      "affiliations": [
        "Medical School, University of Exeter Faculty of Health and Life Sciences, Exeter, UK"
      ],
      "name": "Lesley Collier"
    },
    {
      "affiliations": [
        "School of Social Policy and Society, University of Birmingham, Birmingham, UK"
      ],
      "name": "Jon Glasby"
    },
    {
      "affiliations": [
        "Exeter Clinical Trials Unit, University of Exeter, Exeter, UK"
      ],
      "name": "Bethany Whale"
    },
    {
      "affiliations": [
        "Exeter Clinical Trials Unit, University of Exeter, Exeter, UK"
      ],
      "name": "Phoebe Dawe"
    },
    {
      "affiliations": [
        "Exeter Clinical Trials Unit, University of Exeter, Exeter, UK"
      ],
      "name": "Naomi Burnett-Fry"
    },
    {
      "affiliations": [
        "Medical School, University of Exeter Faculty of Health and Life Sciences, Exeter, UK",
        "NIHR Applied Research Collaboration South West Peninsula, University of Exeter, Exeter, UK"
      ],
      "name": "Linda Clare"
    },
    {
      "affiliations": [],
      "name": "on behalf of the RecoverED team"
    }
  ],
  "title": "Rehabilitation intervention to improve Recovery after an Episode of Delirium in adults over 65 years (RecoverED): a multicentre, single-arm feasibility study in NHS acute hospitals in the UK",
  "uid": "94c3bc72-eca4-5e31-8aba-1104ccc3d38e"
}