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FrailtyNCT04418271

Prehabilitation of Elderly Patients With Frailty Syndrome Before Elective Surgery (PRAEP-GO)

A study testing Prehabilitation- new form of care in people with Frailty and Frail Elderly, run by Charite University, Berlin, Germany at 23 sites in Germany.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aim of the study is to evaluate the effect of a shared decision-making conference and three-week prehabilitation program on the outcome "care dependency" one year after surgery. Read more about this study

Who is it for?
Ages 70 years and older
Conditions the study is for
Frailty, Frail Elderly
What is being tested?
Prehabilitation- new form of care
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,199 participants
Where
23 sitesGermany
Study dates
30 Jun 2020to 19 Dec 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 70 years and older
  • All sexes
  • No healthy volunteers
  • Older adult

Who may be able to join

  • Age ≥ 70 years
  • Consent by Patient or Legal Representative
  • Elective surgery planned
  • Expected anesthesia duration≥ 60 min
  • Statutory health insurance
  • Frailty syndrome (≥1 positive out of 5 standardized parameters according to the Physical Frailty Phenotype according to Fried et. al.)

Who cannot join

  • Severe cardiac or pulmonary disease (NYHA IV, Gold IV)
  • Intracranial interventions
  • Moribund patients (palliative situation)
  • Not enough language skills
  • Participation in another interventional rehabilitation study or other interventional clinical trial that has not been approved by the study management committee (Exception: Participation in adjuvant intervention study)

Trial locations and contacts

23 sites in 1 country.

23 sites in 1 country

Germany23 sites
  • Herz- und Diabetes Zentrum

    Bad Oeynhausen

  • Department of Anesthesiology and Operative Intensive Care Medicine (CBF), Charité - Universitätsmedizin Berlin

    Berlin, 12203

  • Department of Anesthesiology and Operative Intensive Care Medicine CCM/CVK, Charité - Universitätsmedizin Berlin

    Berlin, 13353

  • Auguste-Viktoria-Klinikum - Vivantes - Netzwerk für Gesundheit GmbH

    Berlin

  • Bundeswehrkrankenhaus

    Berlin

  • CARITAS Klinik Maria Heimsuchung

    Berlin

  • Dominikus-Krankenhaus

    Berlin

  • Evangelisches Krankenhaus Hubertus

    Berlin

  • Humboldt-Klinikum - Vivantes - Netzwerk für Gesundheit GmbH

    Berlin

  • Klinikum im Friedrichshain - Vivantes - Netzwerk für Gesundheit GmbH

    Berlin

  • Martin-Luther-Krankenhaus

    Berlin

  • Sankt Joseph Krankenhaus

    Berlin

  • Unfallkrankenhaus Berlin

    Berlin

  • Klinikum Frankfurt Oder GmbH

    Frankfurt (Oder)

  • Universitätsmedizin Greifswald

    Greifswald

  • Universitätsklinikum Hamburg-Eppendorf

    Hamburg

  • Sana Kliniken Sommerfeld

    Kremmen

  • Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Universität zu Lübeck

    Lübeck

  • Klinikum der Universität München, LMU Campus Großhadern

    München

  • Klinikum rechts der Isar - Technische Universität München

    München

  • München Klinik Bogenhausen

    München

  • Havelland Kliniken GmbH - Klinik Nauen

    Nauen, 14641

  • Havelland Kliniken-Klinik Rathenow

    Rathenow, 14712

Other trials in Germany

About this study

Official title: Prehabilitation of Elderly Frail or Pre-frail Patients Prior to Elective Surgery - a Randomized Controlled Multicenter Study (PRAEP-Go)

The aim of the study is to evaluate the effect of a shared decision-making conference and three-week prehabilitation program on the outcome "care dependency" one year after surgery. The cost-effectiveness of the intervention will also be evaluated in this N = 1400 patient, national multicenter, assessor-blinded, randomized, pragmatic, controlled, parallel-group, clinical trial.

The objective of PRÄP-GO is to establish and employ a suitable preoperative case-care management system to improve the short and long-term outcome of elderly surgical patients with signs of a frailty syndrome, improving postoperative quality of life and reducing care dependency by a three-week individualized prehabilitation program.

Being tested
Prehabilitation- new form of care
Keywords
Prehabilitation, Physiotherapy, Exercise Therapy, Rehabilitation, Nutritional Intervention, Multidisciplinary Intervention, Frailty, Surgery
Medical subject headings
Frailty

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Prehabilitation- new form of careBehavioural

    The participants in the intervention group take part in a shared decision-making (SDM) conference to plan the intervention. The therapeutic content of the prehabilitation is defined individually for each patient in the SDM conference. Prehabilitation will be a structured and individually tailored 3-week program.

Study groups in NCT04418271
Study groupRoleWhat they receive
PrehabilitationExperimentalPrefrail and frail patients receive prehabilitation (new form of care)
Receives: Behavioral: Prehabilitation- new form of care
Standard of CareNo interventionPrefrail and frail patients receive no prehabilitation, but receive standard of care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Degree of care dependency

    Assessment results in a degree of care dependency from personal help according to the German dependency assessment (= "Neues Begutachtungs-Assessment" (NBA)) (Wingenfeld et al., 2008). The results of the assessments ranges between 0 and 100 points, which are transformed into a 0-5 ordinal scale. Higher points in the assessments indicate higher demand of care dependency. Accordingly, higher numbers on the ordinal scale indicate a higher level of care dependency as defined in the German statutory care insurance program.

    Measured: Up to one year

Secondary outcomes (35)
  1. Barthel Index

    Level of care dependency after surgery reported as Barthel Index

    Measured: Up to one year

  2. Change in NBA score

    Assessment results according to the German dependency assessment (= "Neues Begutachtungs-Assessment" (NBA)) (Wingenfeld et al., 2008) using the results of the assessments on the scale from 0 to 100 points

    Measured: Up to one year

  3. NBA domain change

    Change in individual domains of the German dependency assessment (= "Neues Begutachtungs-Assessment" (NBA)).

    Measured: Up to one year

  4. Surrogate for Neurocognitive Disorder (NCD)

    Frequency of neurocognitive vulnerability at 3 or 12 months as surrogate for NCD is measured as composite score:

    1. Frequency of cognitive impairment/vulnerability is calculated from a change in composite of MiniCog, ANT, TMT-B and MOCA
    2. subjective concern (MMQ) and
    3. IADL/ADL

    Measured: Up to one year

  5. Screening tool for cognitive vulnerability

    Cognitive vulnerability is suspected by limited MiniCog-test result. The MiniCog consists of two items, the word recall test and the clock-drawing test. Performance in these test is rated on a scale ranging from 0 - 5, with <3 points indicating a cognitive vulnerability.

    Measured: Up to one year

  6. Dementia risk assessed by MOCA

    Dementia risk is assessed by Montreal Cognitive Assessment (MOCA-30) deterioration (change) and its absolute value if < 26.

    Measured: Up to one year

  7. Delirium

    Delirium as perioperative complication assessed until hospital discharge using billing data.

    Measured: Up to one year

  8. Frailty

    Frailty is operationalized using modified Fried frailty criteria. Frailty scores from 0 to 5 (i.e., 1 point for each component; 0 = best to 5 = worst) represent robust (0), pre-frail (1-2), and frail (3-5) health status.

    Measured: Up to one year

  9. Perioperative complications by Clavien-Dindo

    Perioperative complications assessed using Clavien Dindo till hospital discharge

    Measured: Up to hospital discharge

  10. Every mobility

    Level of everyday mobility using Life-Space Assessment (LSA)

    Measured: Up to one year

  11. Autonomy Preference

    Extent of patients' autonomy preference concerning medical decisions; Autonomy-Preference-Index, modified German version (API-Dm). The scale consists of a 11-item questionnaire with 4 questions on preferred autonomy in health-related decisions and 7 items on information preference. The total results of the API and both subscales are transformed into a 0 - 100 scale with higher values indicating higher levels on autonomy and information preference, respectively.

    Measured: At the beginning of the observation

  12. Extent of involvement in shared decision-making process

    Extent of patients, relatives and health professionals' involvement in shared decision-making process; 9-Item Shared Decision Making Questionnaire (SDM-Q-9/SDM-Q-Doc)

    Measured: At the beginning of the observation

  13. Arm circumference

    Arm circumference is measured in a standardized position and documented in centimeter.

    Measured: Up to one year

  14. Calf circumference

    Calf circumference is measured in a standardized position and documented in centimeter.

    Measured: Up to one year

  15. Nutritional Status

    Changes of nutritional status after elective surgery.

    Measured: Up to one year

  16. Change in body weight

    Changes in body weight measured in kg.

    Measured: Up to one year

  17. Instrumental Activities of daily living (IADL)

    Instrumental Activities of daily living (IADL) using the questionnaire by Lawton and Brody.

    Measured: Up to one year

  18. Functional endurance

    Functional endurance is measured using the 2-Minute-Step-Test (2-MST). The patient steps in place, raising each leg to a marker. The markers height is derived from biometrical measures of the patient. The assessor counts each step of the right leg in which the knee of the patient passes the marker. Higher counts of steps indicates better functional endurance.

    Measured: Up to one year

  19. Function of the respiratory system

    The function of the respiratory system is assessed by expiratory peak flow measurement as surrogate parameter.

    Measured: Up to one year

  20. Depression

    Depression is measured by frequency of depressive symptoms; Patient Health Questionnaire-8 (PHQ-8)]

    Measured: Up to one year

  21. Anxiety

    Anxiety is measured frequency of anxiety symptoms; Generalized Anxiety Disorder Scale-7 (GAD-7)

    Measured: Up to one year

  22. Health related quality of life

    Health related quality of life is measured with EQ-5D-5L questionnaire.

    Measured: Up to one year

  23. Disability by WHODAS 2.0

    Patient- or proxy-reported functioning and disability is measured by the WHO Disability Assessment Schedule (WHODAS 2.0, 12-item version.

    Measured: Up to one year

  24. Falls

    Incidence of falls

    Measured: Up to one year

  25. Fear of Falling

    Activities-Specific Balance Confidence (ABC)-6-Scale. The scale consists of 6 questions who are rated on a 0-100 NRS-scale. The total result of the ABC-6-scale comprises of the average of all 6 items.

    Measured: Up to one year

  26. Satisfaction with the intervention: ZUF-8

    The satisfaction of the patient is measured with the questionnaire on patient satisfaction (ZUF-8). The ZUF-8 is a questionnaire on patient satisfaction after treatment. It consists of 8 questions which results in a score between 0 and 24 points, with higher values.indicating higher levels of satisfaction.

    Measured: Up to one year

  27. Mortality

    Data from patient records and residents' registration

    Measured: Up to one year

  28. Muscle strength

    Muscle strength measured by handgrip strength

    Measured: Up to one year

  29. Functional mobility

    Functional mobility is measured with gait speed over 15ft

    Measured: Up to one year

  30. Stair climbing speed

    Stair climbing speed test

    Measured: Up to one year

  31. Timed Up & Go Test (TUG

    Timed Up \& Go Test (TUG) to test mobility and body balance

    Measured: Up to one year

  32. Postoperative functional mobility

    Postoperative complication of mobilization speed measured with CHARMI

    Measured: Up to one year

  33. Length of stay Intensive Care Unit

    Intensive care unit length of stay describes every day spent in an ICU bed.

    Measured: Participants are followed up for the duration of rehabilitation, an expected average of 1 day]

  34. Admission Intensive Care Unit (ICU) Admission rate on Intensive Care Unit (ICU)

    Admission rate (planned / unplanned) on ICU

    Measured: Participants are followed up for the duration of rehabilitation, an expected average of 1 day]

  35. Duration of hospital stay

    Time in hospital

    Measured: Participants are followed up for the duration of rehabilitation, an expected average of 7 days]

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Jun 2020
  2. Study start30 Jun 2020
  3. Primary completion1 Aug 2024
  4. Study completion19 Dec 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
Patients with frailty syndrome (≥1 of the standardized parameters (Pre-Frail = 1-2; Frail≥3) according to Fried et al.(2001) are offered randomised participation in the new form of care.
Masking
None (open label)
Enrolment
1,199 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04418271
Sponsor's protocol ID
PRAEP-GO
Other IDs
U1111-1253-4820
Status last verified
Feb 2025
First submitted
19 May 2020
Last updated
19 Feb 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Spies C, Schmidt K, Kiselev J, Buchka S, Blobner M, Borchers F, Fabian M, Loidl V, Marschall U, Morgeli R, Nau C, Otto M, Rombey T, Saller T, Schulz M, Treskatsch S, Busse R, Mansmann U, Schaller SJ; PRAEP-GO consortium and PRAEP-GO investigators. Supervised multimodal prehabilitation of older patients with frailty or prefrailty before elective surgery: a multicentre randomised controlled outcome assessor-blinded trial. Lancet Healthy Longev. 2026 Sep 15:100899. doi: 10.1016/j.lanhl.2026.100899. Online ahead of print.

    PubMed 42743945
  • Rombey T, Eckhardt H, Quentin W, Weber Z, Buchka S, Kiselev J, Loidl V, Mansmann U, Schaller SJ, Schmidt K, Spies C, Busse R, Schoner L. Cost-effectiveness of prehabilitation for elderly (pre-)frail patients prior to elective surgery compared to standard care - an economic evaluation from a societal perspective. BMC Med. 2026 May 21;24(1):326. doi: 10.1186/s12916-026-04933-6.

    PubMed 42163295
  • Schone C, Fuchs TI, Kiselev J, Schmidt K, Schaller SJ, Spies C, Rombey T. Facilitators and barriers to participation in prehabilitation prior to orthopaedic elective surgery - a qualitative study with elderly (pre-)frail patients. BMC Geriatr. 2025 Nov 4;25(1):845. doi: 10.1186/s12877-025-06592-3.

    PubMed 41188708
  • Eckhardt H, Quentin W, Silzle J, Busse R, Rombey T. Cost-effectiveness of prehabilitation of elderly frail or pre-frail patients prior to elective surgery (PRAEP-GO) versus usual care - Protocol for a health economic evaluation alongside a randomized controlled trial. BMC Geriatr. 2024 Mar 6;24(1):231. doi: 10.1186/s12877-024-04833-5.

    PubMed 38448804
  • Schaller SJ, Kiselev J, Loidl V, Quentin W, Schmidt K, Morgeli R, Rombey T, Busse R, Mansmann U, Spies C; PRAEP-GO consortium,; PRAEP-GO investigators. Prehabilitation of elderly frail or pre-frail patients prior to elective surgery (PRAEP-GO): study protocol for a randomized, controlled, outcome assessor-blinded trial. Trials. 2022 Jun 6;23(1):468. doi: 10.1186/s13063-022-06401-x.

    PubMed 35668532

Questions about this trial

What is this clinical trial studying?

A study testing Prehabilitation- new form of care in people with Frailty and Frail Elderly, run by Charite University, Berlin, Germany at 23 sites in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 23 sites in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Degree of care dependency (time frame: Up to one year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04418271, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Feb 2025.

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