Many people have multiple health conditions, but most health services have been designed to deal with one problem at a time. The new £2.3 million CHART trial aims to test a new care approach called Comprehensive Geriatric Assessment (CGA) to improve independence in older people who live with both heart failure and frailty. From February 2025, the trial will be recruiting people across England in the North West, South West, and the Yorkshire & Humber region.
CGA involves older people as well as their families, carers and healthcare professionals to identify and help manage multiple problems in health and daily life and prevent new ones arising. It includes creating a plan to address concerns identified by the older person (as well as their family and carers, where relevant) and agreeing interventions to support the plan. The plan, interventions and support are reviewed and adapted over time to support changing individual needs.
The trial aims to see if CGA in addition to usual care helps people with heart failure and frailty maintain or improve everyday activities. This will be compared with people getting usual care alone.
The CHART trial is co-led by Professor Vicki Goodwin, Professor of Ageing and Rehabilitation at the University of Exeter and NIHR ARC South West Peninsula (PenARC) Lead for Ageing and Professor Andy Clegg, Professor of Geriatric Medicine at the University of Leeds and NIHR ARC Yorkshire & Humber.
Professor Goodwin said:
“Frailty is a condition that is common in older age. It develops because as we get older, our bodies change and can lose their resilience. This means that older people with frailty can experience sudden, dramatic changes in their wellbeing when they have health problems. In heart failure, the heart muscle doesn’t pump blood as well as it should because it has become too weak or stiff. Some people have symptoms of heart failure even though their heart pumps blood well. Many older people are living with both heart problems and frailty.
“There is limited scientific evidence on how best to support older people living with both heart problems and frailty. The CHART study will test personalised and holistic care that will enable older people to do what is important to them.”
Professor Amanda Farrin, Professor of Clinical Trials and Evaluation of Complex Interventions at the University of Leeds Clinical Trials Research Unit said
“Evidence shows that CGA can be effective at increasing independence in people with frailty in hospital and the community. However, it hasn’t been tested for older people living with both frailty and heart failure, which is why this new trial is very important.”
The trial is a collaboration between the Universities of Exeter, Leeds and Liverpool, along with Bradford Teaching Hospitals NHS Foundation Trust, Northern Care Alliance NHS Foundation Trust, and the NIHR Applied Research Collaborations South West Peninsula (PenARC) and Yorkshire & Humber (YHARC). It is funded by the National Institute for Health and Care Research (NIHR).