Monash awarded $3M for trial for PERFORM exercise rehabilitation trial
Prof Anne Holland (Left) will lead the Australian trials
Monash University is partnering with the NIHR Leicester Biomedical Research Centre, University of Leicester and University of Glasgow to undertake a multi-million-dollar trial to evaluate a UK-designed exercise rehabilitation model to help people with multiple chronic health conditions.
Multimorbidity, the coexistence of two or more long-term conditions, affects 4.9 million Australians. People with multimorbidity have high levels of disability and psychological distress and are 2.5 times more likely to be hospitalised than those without multimorbidity. Despite strong evidence for the benefits of exercise-based rehab in many long-term conditions, healthcare systems have not traditionally provided rehabilitation services targeted at people with multimorbidity.
A UK university research consortium comprising the University of Leicester, University of Glasgow, University of Birmingham, University of Salford, University of York and University of Exeter co-designed an exercise rehabilitation model with patients, caregivers, health professionals and policymakers to provide effective care for people with multimorbidity, who are frequently excluded from single disease rehabilitation models.
The PERFORM (Personalised Exercise Rehabilitation FOR people with Multimorbidity) trial will test this model in Australia and the UK. Researchers will evaluate the effectiveness of PERFORM in people who are excluded from existing single-disease rehabilitation models and compare outcomes of PERFORM to traditional heart and lung rehabilitation programs.
“The PERFORM clinical trial addresses outcomes that matter to people living with multimorbidity (quality of life, physical function) and are of critical importance to our health system (hospital admission),” said Monash University’s Professor Anne Holland, who will lead the Australian trials.
“If successful, multimorbidity exercise rehabilitation can be rapidly implemented in practice to improve health and wellbeing for people with multimorbidity, and substantially reduce healthcare costs.”
Exercise rehabilitation is a highly effective treatment for people with a single long-term condition such as heart or lung disease, and for these conditions it is considered critical to evidence-based healthcare across the world. However, the potential of exercise rehabilitation to improve health outcomes in multimorbidity is unrealised.
The trial will test two different models of exercise rehabilitation: one for people eligible for existing heart and lung rehabilitation programs, and a second for those without rehabilitation options (other chronic conditions such as stroke, dementia, orthopaedic problems, and diabetes).
It will involve more than 2000 participants and be conducted at 9 sites in Australia (funded by a $3 million grant from the Medical Research Future Fund) and 12 sites in the United Kingdom (funded by the National Institute for Health and Care Research (NIHR)).
It is the largest trial of its kind, and the only one large enough to look at important outcomes like hospital admissions. It will include health economic evaluation and an embedded process evaluation to support future decisions on implementation in Australia and the UK.
Professor Sally Singh, Head of Pulmonary and Cardiac Rehabilitation at the University of Leicester and UK based chief investigator on the trial said: "PERFORM is a great opportunity to establish more effective treatment and rehabilitation protocols for people suffering from multimorbidity - which affects millions of people here in UK.
"So often those suffering from co-morbidities are denied the chance to access research and care that could really benefit them. With this trial we hope to improve patients' quality of life and address the disproportionately high levels of hospitalisation we've observed.
“This will also be a great chance to collaborate with our colleagues at Monash. By undertaking this international collaboration, we shall be able to access a wider pool of data, providing us with a better foundation for our study. This could enable us to establish better practices on a global scale and help a wider range of communities worldwide.”
Professor Rod Taylor, Professor of Population Health Research at the University of Glasgow, added: “This is a unique opportunity for UK and Australian researchers to come together replicate the evaluation of important new intervention designed to improve the outcome of people of multimorbidity. This research combined research investment and effort offer the promise of impacting the future management of the growing global challenge of increasing prevalence and unmet health of people with multimorbidity in our society.”
The trial will begin recruiting participants in 2024. Learn more about Prof Anne Holland’s work here or contact her directly with any enquiries at Anne.Holland@monash.edu.
About Monash University
Monash University is Australia’s largest university with more than 80,000 students. In the 60 years since its foundation, it has developed a reputation for world-leading high-impact research, quality teaching, and inspiring innovation.
With four campuses in Australia and a presence in Malaysia, China, India, Indonesia and Italy, it is one of the most internationalised Australian universities.
As a leading international medical research university with the largest medical faculty in Australia and integration with leading Australian teaching hospitals, we consistently rank in the top 50 universities worldwide for clinical, pre-clinical and health sciences.
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