Delivering a primary care intervention to reduce frailty and improve resilience in people experiencing homelessness: a pilot feasibility study

BACKGROUND: People experiencing homelessness (PEH) are disproportionately affected by frailty, yet few interventions have targeted this syndrome in this population. AIM: To assess the feasibility, and potential impact of a combined exercise and nutritional intervention for PEH living with, or at risk of, frailty. DESIGN & SETTING: A single-arm feasibility trial in a GP clinic for PEH in the Republic of Ireland. METHOD: A two-month exercise and nutritional intervention tailored for PEH was offered to potential participants. Individuals with, or at risk of, frailty attending a GP clinic for PEH in the Republic of Ireland were invited to participate. The primary outcome was feasibility, which was assessed using Bowen's framework. Secondary outcomes were based on potential impact and included frailty scores (Clinical Frailty Scale [CFS] and Survey of Health, Ageing and Retirement in Europe-Frailty Instrument [SHARE-FI]) and weight. A process evaluation explored participant experience. RESULTS: Of 124 eligible individuals, 108 (87.1%) enrolled, and 75 (69.4%) completed follow-up. Among those followed up, 70 (93.3%) engaged with at least one component of the intervention, with the majority finding the intervention easy to follow. CFS and SHARE-FI scores improved following the intervention in those followed-up. CONCLUSION: This study supports the feasibility of a primary care-based exercise and nutritional intervention for PEH living with frailty. The intervention appeared to be safe and to improve the frailty status of participants. It can also be used to inform the design of a definitive trial.