TOPLINE:

In pre-frail and frail adults experiencing homelessness, a primary care intervention combining exercise and nutrition supplementation showed feasibility, with over 85% enrolling and nearly 70% completing the follow-up.

METHODOLOGY:

• Researchers conducted a single-arm feasibility trial in a GP clinic in Dublin, including 124 adults experiencing homelessness, recruited from August 2024 to January 2025, focusing on a combined exercise and nutrition intervention.
• Participants were pre-frail or frail, with frailty assessed using the Clinical Frailty Scale and Survey of Health, Ageing and Retirement in Europe (SHARE)-Frailty Instrument.
• The 2-month exercise and nutrition intervention included exercise instructions provided via leaflets, focusing on strength, balance, and resistance. No special equipment was required, and a daily oral supplement containing 18 g of protein was included.
• Adherence to the intervention was supported by follow-up calls and participant feedback.
• The primary outcome was feasibility, assessed using Bowen's framework, focusing on engagement, follow-up rates, ease of use, and perceived health impact. Exploratory secondary outcomes included changes in frailty scores and weight.

TAKEAWAY:

• The intervention was feasible — of 124 eligible individuals, 87.1% consented to participate, and most found it easy to use; 69.4% completed the 2-month follow-up.
• Among participants followed up at 2 months, 93.3% engaged with at least one component of the intervention. Participants with frailty had lower odds of adherence to exercise than pre-frail participants (odds ratio, 0.29; P = .046).
• The intervention was integrated into primary care without additional resources. Participants reported perceived health benefits over 2 months, with 30.7% feeling much better and 41.3% feeling slightly better after the intervention.
• Frailty scores improved, with Clinical Frailty Scale scores decreasing and SHARE-Frailty Instrument scores falling from 2.19 to 1.09 (P < .001).

IN PRACTICE:

"Future implementation of frailty interventions could benefit from multidisciplinary input, particularly from Inclusion Health teams, addiction specialists, alongside holistic assessment of mental health and social needs. Individuals transitioning to supported housing may be key targets, as housing stability could facilitate frailty reversal," the authors wrote. "Participant experiences highlighted that engagement is shaped by homelessness-related instability, with insecure accommodation, illness, and pharmacy access disrupting participation," they added.

SOURCE:

The study was led by Thomas Cronin of the Irish College of General Practitioners/Discipline of Public Health and Primary Care, School of Medicine, Trinity College Dublin, Dublin, Ireland. It was published online on January 05, 2026, in BJGP Open.

LIMITATIONS:

Individuals with severe frailty were excluded, the recruitment was conducted at a single centre, and the study had an open-label design.

DISCLOSURES:

One author was supported by the Irish College of General Practitioners Aspire Post-CSCST Fellowship award. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.