Effects of a modular intervention on mobility and activities of daily living in geriatric patients in an acute hospital settings – results of the stepped-wedge cluster-randomized redurisk study

BACKGROUND: Hospitalization increases the risk of reduced mobility and diminished activities of daily living (ADL) in geriatric patients. Using a multimodal intervention including delirium prevention, mobility training, care planning, and polypharmacy management, the ReduRisk project aimed to mitigate these risks through a risk-adapted nursing approach. AIMS: This paper seeks to describe the results of the multimodal ReduRisk study on the mobility and ADL in hospitalized geriatric patients. We hypothesized that patients in the intervention group will have better mobility and ADL than those in the control group. METHODS: A monocentric, cluster-randomized trial enrolled a total of N = 589 participants. Clusters were based on different department at the University Hospital of Freiburg. Data collection occurred at three measurement points (hospital admission, discharge, and six months post-discharge) using the Barthel Index (ADL) and the Short Physical Performance Battery (SPPB, mobility). Multilevel analyses were conducted. RESULTS: Of the N = 589 participants, 48% were female. Average age was 79.57 years (SD = 5.44 years). In the intervention group (IG), mobility significantly improved between t0 and t1 (β = 0.27; p