Poster Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2026

Recruitment for a randomised type 1 comparative effectiveness-implementation to reduce frailty in mildly frail older adults in Australia: preliminary insights (#218)

Natasha Reid 1 2 , Adrienne M Young 1 2 , Loretta Baldassar 3 , Mark Chatfield 1 , Anja Christoffersen 1 2 , Tracy Comans 1 4 , Christopher Etherton-Beer 5 , Maria Fiatarone Singh 6 , Emily Gordon 1 7 , Chandana Guha 6 , Gillian Harvey 8 , Genevieve N Healy 1 , Lisa Kouladjian 6 , Michelle Miller 8 , Mark Morgan 9 , Rosemary Saunders 3 , Paul Yates 10 11 , Ruth Eleanor Hubbard 1 2 12
  1. The University of Queensland, Brisbane, QLD, Australia
  2. Australian Frailty Network, Brisbane, QLD
  3. Edith Cowan University, Perth, WA, Australia
  4. National Ageing Research Institute, Melbourne, Australia
  5. University of Western Australian, Perth, WA, Australia
  6. University of Sydney, Sydney, NSW, Australia
  7. Australian Frailty Network, Brisbane
  8. Flinders University, Adelaide, SA, Australia
  9. Bond University, Gold Coast, QLD, Australia
  10. Austin Health, Melbourne, VIC, Australia
  11. The University of Melbourne, Melbourne, VIC, Australia
  12. Princess Alexandra Hospital, Brisbane, QLD, Australia

Aims: To present recruitment challenges of a trial comparing the effectiveness, cost-effectiveness and implementation of a supervised, multicomponent frailty management program plus health coaching versus a self-directed, online program in reducing frailty among mildly frail, community‑dwelling older adults in Australia.

Methods: FITTEST is an Australia-wide, parallel-group, individually randomised, type 1 hybrid comparative effectiveness–implementation trial. Community-dwelling adults ≥65 years with mild frailty (Frailty Index [FI] 0.15–0.35) are randomised to: (1) a supervised multicomponent intervention focused on four pillars. Exercise: combining clinic-based high intensity progressive resistance and home-based balance training; Diet: dietetic assessment and tailored advice via telehealth; Medication Optimisation: an online medication optimisation tool supported by goal-setting; and Social Support: structured engagement strategies, reinforced through health coaching calls over 6 months; or (2) a self-directed program delivered via a purpose-built website providing resources, behaviour change tools, and goal-setting supports across the four pillars. The primary outcome is change in FI at 6 months.

Results: Recruitment is ongoing. To date, 260 expressions of interest have been received, 235 screened, 71 eligible, 57 consented, and 50 randomised. Reasons for non-participation include time commitment, transport barriers, loss of interest, and FI outside the eligibility range. Key challenges and the necessary expansion of inclusion criteria to facilitate recruitment are discussed.

Conclusions: Early findings highlight limitations of recruiting solely through geriatric services due to limited numbers meeting frailty and participation criteria. Expanding to broader community recruitment substantially improved enrolment. Additional barriers include participant preferences for specific intervention arms and logistical challenges organising clinic-based exercise.