Effect of monitoring frailty through a mobile application and a sensor kit to prevent functional decline in frail and prefrail older people: the FACET pilot randomized control trial (Preprint)

BACKGROUND Frailty represents a state of susceptibility to stressors and constitutes a dynamic process. Untreated, this state can progress to disability. Hence, timely detection of alterations in patients' frailty status is imperative to institute prompt interventions and impede progression. With this aim, the FACET technological ecosystem has been developed to provide clinically gathered data from the home to a medical team for early intervention. OBJECTIVE To assess whether the FACET technological ecosystem prevents frailty progression and improves frailty status, according to the Frailty Phenotype and FTS-5, at 3 and 6 months of follow-up. METHODS This randomized clinical trial involved 90 older adults aged 70 years or above meeting 2 or more Fried Frailty Phenotype Criteria, having 4 or more comorbidities, and having supervision at home. The study was conducted between August 2018 and June 2019 at geriatrics outpatient clinic in Getafe University Hospital and Albacete University Hospital. Participants were randomized into a control group, receiving standard treatment, and the intervention group, receiving standard treatment along with the home monitoring system (FACET). The system monitored functional test at home (gait speed, chair stand test, frailty status and weight). Outcomes were assessed using multivariate linear regression models for continuous response and multivariate logistic models for dichotomous response. P-values lower than 0.05 were considered statistically significant. RESULTS The mean age was 82.33 years old, with 27.78% being male. Participants allocated to the intervention group showed a 73% reduction in the risk of deterioration by FTS-5 score (p-value = 0.04) and 92% lower likelihood of worsening by 1 point according to Fried Frailty Phenotype Criteria compared to the control group (p-value = 0.02) at 6-months of follow-up. Frailty status, when assessed through FTS-5, improved in the intervention group at 3 (p-value = 0.004) and 6 months (p-value = 0.047), while when the Frailty Phenotype Criteria were used, benefits were shown at 3 months of follow-up (p-value = 0.03), but not at 6 months. CONCLUSIONS The FACET technological ecosystem helps in the early identification of changes in the functional status of prefrail and frail older persons, facilitating prompt clinical interventions thereby improving health outcomes in terms of frailty and functional status, thus potentially preventing disability and dependency. CLINICALTRIAL NCT03707145