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Grip Strength Routine Implementation (GRImP)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT02447445
Recruitment Status : Completed
First Posted : May 18, 2015
Last Update Posted : April 19, 2018
National Institute for Health Research, United Kingdom
Information provided by (Responsible Party):
University Hospital Southampton NHS Foundation Trust

Brief Summary:
Hand grip strength (GS) is a non-invasive marker of whole body skeletal muscle strength and function used in research and recommended as a simple inexpensive measure suitable for clinical use. Research has shown that low GS in hospital inpatients is associated with poor healthcare outcomes including increased postoperative complications, longer length of stay, increased functional limitations and disability. Measuring GS on admission to hospital has the potential to identify people at risk of poor healthcare outcomes allowing early intervention including focus on nutrition and mobility. Yet, GS measurement is not routinely used in clinical practice. The aim of this study is to evaluate the implementation of GS measurement into routine clinical practice in Medicine for Older People wards at UHS.

Condition or disease Intervention/treatment
Frail Elderly, Inpatients Procedure: Grip strength assessment

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Study Type : Observational
Actual Enrollment : 100 participants
Observational Model: Case-Only
Time Perspective: Other
Official Title: Implementing Grip Strength Measurement Into Routine Clinical Practice; a Feasibility Study (GRImP)
Study Start Date : July 2015
Actual Primary Completion Date : December 2016
Actual Study Completion Date : January 2017

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Flu

Group/Cohort Intervention/treatment
Older inpatient at MOP
The group includes older patients who are admitted to one of the Medicine for Older Patients (MOP) wards. Grip strength will be part of the routine assessment of older patient when admitted to MOP.
Procedure: Grip strength assessment
Grip strength will be measured by the ward nurse using a Jamar dynamometer by asking the patient to squeeze with each hand twice, starting with the right hand using the standardised protocol The maximum GS measurement will be recorded. Patients who have low maximum GS values (men < 27 kg and women <16 kg) or those who are unable to perform the test will receive a care plan. The care plan will focus on review of dietary energy and protein intake and any need for oral nutritional supplements or dietetic review, and review of mobility with any need for physiotherapy review with regard to progressive resistance exercises to increase muscle strength.

Primary Outcome Measures :
  1. The feasibility and acceptability of routine implementation of grip strength assessment in older patients [ Time Frame: 6-9 months ]
    is it feasible to implement grip strength assessment routinely in Medicine for Older People (MOP) wards ? This will be determined by recording the proportion of older inpatients admitted to MOP wards who had their grip strength been measured and the percentage among them with low grip strength levels. The acceptability of routine implementation of grip strength will be assessed through qualitative method (interviews and focus groups) with older inpatients, medical staff, nursing staff, therapy and dietetic teams.

Secondary Outcome Measures :
  1. The proportion of referrals to dietetic teams and the proportion of nutritional supplements prescriptions [ Time Frame: After 3 months of routine implementation of grip strength ]
    When routine GS measurement has been implemented and embedded in clinical practice for at least 3 months, the number (or percentage) and reasons for referrals to the dietetic weekly for the preceding 3 months will be extracted from the E-referrals and will be compared to the numbers collected at the baseline. The number (or percentage) of ONS prescriptions will also be calculated from electronic prescribing system and compared to the baseline figures.

  2. Costs of implementing grip strength assessment routinely in MOP [ Time Frame: 9-12 months ]
    A cost analysis will include the implementation costs and NHS resource utilisation. The implementation costs will involve cost of equipment, recalibration, nurses training by band, and note audits. Resource use information will be collected as part of the study and those will include: nutritional prescriptions, referral to dietician, length of stay and discharge destination. The results will be presented as cost per patient detected and cost per unit of 120 beds.

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Ages Eligible for Study:   80 Years and older   (Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population
Grip strength of older patients admitted to the MOP will be measured by a ward nurse.

Inclusion Criteria:

Inclusion criteria will be older patients admitted to the MOP.

Exclusion Criteria:

Exclusion criteria will be an inability to hold the dynamometer in either hand (eg pain and/or severe arthritis), inability to understand the explanation given (eg severe dementia or delirium), and terminal phase of illness.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT02447445

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United Kingdom
Southampton Genral Hospital
Southampton, United Kingdom, SO16 6YD
Sponsors and Collaborators
University Hospital Southampton NHS Foundation Trust
National Institute for Health Research, United Kingdom
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Study Chair: Helen Roberts, PhD University General Southampton UHS
Additional Information:
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: University Hospital Southampton NHS Foundation Trust Identifier: NCT02447445    
Other Study ID Numbers: RHM MED1250
First Posted: May 18, 2015    Key Record Dates
Last Update Posted: April 19, 2018
Last Verified: April 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided