Prehabilitation of elderly patients with frailty syndrome before elective surgery (PRÄP-GO).
- © PRÄP-GO
Almost 16 million surgeries are performed in German hospitals each year. About 40% of those are performed in patients over 70 years of age. With increasing age, a patient’s functional reserve usually decreases and some patients develop frailty syndrome. Frailty syndrome describes a state of reduced mobility, muscle strength and physiological reserves. Patients with frailty syndrome have a higher risk of experiencing postoperative complications, impacting their individual autonomy and quality of life.
PRÄP-GO aims to maintain or improve the individual autonomy of patients with frailty syndrome undergoing surgery and prevent them from becoming care-dependent.
All patients over 70 years of age scheduled for surgery in one of the 12 participating centres are screened for frailty syndrome. Of those with frailty syndrome, 1,400 patients will randomly be allocated to one of two groups. Patients in the intervention group receive preoperative treatment (prehabilitation) for some symptoms of their frailty syndrome. The treatment goals, contents and setting (inpatient/outpatient) are determined beforehand in a shared decision-making conference. Patients in the control group receive standard preoperative treatment.
The groups are compared regarding patients’ care dependency one year after their surgery (primary outcome). Other outcomes include further health (economic) parameters, such as the patients’ quality of life. Furthermore, the potential of implementing PRÄP-GO as a new model of care in Germany will be evaluated.
The project receives funding from the Innovation Fund of the Federal Joint Committee for three years (approx. 8.7 million Euro overall).
PRÄP-GO is led by Charité Berlin. The Department of Health Care Management is responsible for evaluating the cost-effectiveness and scale-up potential of PRÄP-GO. Other project partners include Ludwig Maximilians University of Munich, BARMER, St. Joseph Hospital Berlin-Tempelhof GmbH, Hausarztpraxis Landgraf and the Institute for General Medicine of the MHB-Fontane.
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