REFRESH_V1.0
Research type
Research Study
Full title
nutRition intervEntions For malnouRished oldEr adultS in care Homes (REFRESH) – a parallel, superiority, three-arm cluster randomised controlled trial
IRAS ID
334241
Contact name
Mary Hickson
Contact email
Sponsor organisation
University of Plymouth
Duration of Study in the UK
3 years, 2 months, 31 days
Research summary
People who live in care homes are more at risk of malnutrition. Malnutrition harms their health, reduces their quality of life, and increases the risk of falls and infections. They need more General Practitioner (GP) and hospital appointments, and experience slow recovery from illness. Treating malnutrition costs a huge amount; estimated at over £23 billion a year in health and social care. Currently, the recommended first approach for treating malnutrition in care homes is to provide food with extra protein, calories, vitamins, and minerals (fortified foods - FF). If that is not enough, the second approach is to use powdered or liquid supplements (oral nutritional supplements - ONS). However, the evidence supporting these approaches is limited, and it is unknown which is the best approach in care homes.
The REFRESH study aims to test how best to treat malnutrition in older care home residents. 90 care homes and 1,530 residents at risk of malnutrition will be recruited. Each care home will be randomly put into one of the following groups and their participants will receive this approach to treating malnutrition for 12 months: oral nutritional supplements, fortified food and drink, usual care (treatment as usual).
Information will be collected about the residents at the start of the trial, and then at six and 12 months after the start. The information collected will include quality of life, nutritional status, weight, activities of daily living, and costs of the use of prescribed oral nutritional supplements and the NHS services.
Those who often do not have the opportunity to take part in research - for example, those from ethnic minority groups and people who depend on others to make their decisions - will be included.
REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
25/WM/0154
Date of REC Opinion
7 Oct 2025
REC opinion
Further Information Favourable Opinion