Implementing an innovative preventative health trial in a regional setting - lessons learnt

Abstract

Introduction: The South West region of Victoria features a higher-than-average ageing demographic. In the 2021 Australian Bureau of Statistics census, 22.1% of Victoria ’ s south west coast population was aged 65 or older, compared with the Victorian average of 16.8%. One of the biggest challenges to healthy ageing is frailty, however, frailty prevention and management is poorly understood. To address this, South West Healthcare (SWH) partnered with the University of Queensland (UoQ) to implement the FITTEST trial, which evaluates supervised versus self-directed programs to reduce frailty in eligible community members. As the first geriatric trial supported by the SWH Clinical Trials Unit (CTU), this abstract evaluates the feasibility process, implementation strategies and operational outcomes of establishing a novel tele-trial in a regional setting. Feasibility and Implementation: The implementation of the FITTEST trial at SWH highlighted several systemic and protocol challenges and opportunities. The challenge of a rigid protocol design that had not been real-world tested was overcome with the CTU providing advice to UoQ on protocol amendments to adapt the trial to the existing healthcare system. Maintaining appropriately trained trial staff across two years in a busy hospital setting has required flexibility and innovation. Funding constraints have also required creative approaches to delivering the trial, including the use of funding from the Australian Teletrial Program. Other opportunities included an unplanned but informative survey of over 65 local elderly residents which demonstrated the strength of existing frailty prevention services in our region. The trial has fostered inter-department collaboration between the CTU and Physiotherapy Department, and allowed two existing SWH staff to undertake research investigator roles for their first time. Conclusion:Implementation of the FITTEST trial at SWH has provided an innovative model for delivering preventative health care close to home. As a regional site participating in this trial, SWH has been able to provide invaluable feedback to the UoQ regarding both design and implementation of the trial in a regional setting. Implementation learnings have also been incorporated into the SWH CTU feasibility process. This provides organisational-wide strength in ensuring our local population has access to trials that bring the most benefit, closer to home.