Improving exercise training for sarcopenia or frailty: Results from wave 2 of the BEPOP benchmarking and feedback initiative

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Samantha Hartley1, Alexandria Cropp2, Susanne Arnold3, Charlotte Buckland4, Sarah De Biase5, Christopher Hurst6,7, Rhian Milton-Cole8,9, Avan A Sayer6,7, Dawn Skelton10, Miles D Witham6,7
1. Sunderland Hospital, UK; 2 RVI, UK; 3. University of Warwick, UK; 4. RVI, UK; 5. West Yorkshire ICB, UK; 6. Newcastle University, UK; 7. NIHR Newcastle Biomedical Research Centre, UK; 8. QMUL 9 AGILE, UK 10. Glasgow Caledonian University, UK
Clinical Quality
CQ - Clinical Effectiveness
Quality Improvement

Abstract

Background

Resistance exercise is an effective, but often suboptimally delivered therapy for sarcopenia and physical frailty in older people. The Benchmarking Exercise Programme for Older People (BEPOP) is a UK-wide quality improvement initiative that uses benchmarking and feedback to improve the quality of exercise delivery by physiotherapy services. We present results from wave 2 of BEPOP data collection.

Methods

NHS physiotherapy services across the UK submitted anonymised details for up to 20 consecutive patients referred for sarcopenia or frailty-related reasons. Data included sarcopenia diagnosis, baseline assessment and reassessment method, delivery of intervention (including type and progression of exercise) and signposting to follow-on exercise services. Descriptive data were analysed for five best practice recommendations and compared with results from wave 1 for sites taking part in both.

Results

Twenty-eight sites submitted data for 542 patients, mean age 82 (range 60-104) years, mean Clinical Frailty Score 5. Analysis across all sites showed that 279 (52%) participants had a strength-based assessment prior to programme start and sarcopenia diagnosis was undertaken in 316 (58%) participants by discharge from therapy. 496 (92%) undertook some form of resistance exercise but only 222 (41%) progressed intensity. Only 205 (38%) were reassessed at the end of programme using the same strength-based assessment as baseline and 238 (44%) were signposted or referred to follow-on exercise services. For sites taking part in both wave 1 and wave 2, performance for objective strength assessment improved in wave 2 (64% vs 52%), as did intensity progression (33% vs 11%) and onward referral (40% vs 31%).

Conclusions

We found improvements in several aspects of practice in wave 2 of BEPOP compared to wave 1. There remains considerable room for further improvement in delivery of resistance exercise for older people living with sarcopenia or frailty, which recommendations in the wave 2 report will address.

Comments

Thank you for presenting this study. It's mentioned 38% were reassessed at the end of the programme, what are the reasons for the low reassessment rate? How can these be overcome? How has the team implemented the changes in waves 3 and 4 (if any)? 

Submitted by triciaa.tay_39743 on

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Thank you for your comment triciaa.tay_39743

Difficult to say exactly as it was such a hetergenous QiP and we did not collect qualitative feedback in this round.

We have since arranged a webinar to discuss the results and for sites that performed well to give presentations around what they did to ensure good engagement with all recommendations.

Going forward in waves 3 and 4 we are considering bringing back qualitative aspect of the project (though with more sites recruited this may not be faesible)

 

Submitted by adcropp_12515 on

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