A pragmatic cluster randomised controlled trial of air filtration to prevent symptomatic winter respiratory infections (including COVID-19) in care homes (AFRI-c) in England: Trial protocol.

Publication date: Apr 30, 2024

Respiratory tract infections are readily transmitted in care homes. Airborne transmission of pathogens causing respiratory tract illness is largely unmitigated. Portable high-efficiency-particulate-air (HEPA) filtration units capture microbial particles from the air, but it is unclear whether this is sufficient to reduce infections in care home residents. The Air Filtration to prevent symptomatic winter Respiratory Infections (including COVID-19) in care homes (AFRI-c) randomized controlled trial will determine whether using HEPA filtration units reduces respiratory infection episodes in care home residents. AFRI-c is a cluster randomized controlled trial that will be delivered in residential care homes for older people in England. Ninety-one care homes will be randomised to take part for one winter period. The intervention care homes will receive HEPA filtration units for use in communal areas and private bedrooms. Normal infection control measures will continue in all care homes. Anonymised daily data on symptoms will be collected for up to 30 residents. Ten to 12 of these residents will be invited to consent to a primary care medical notes review and (in intervention homes) to having an air filter switched on in their private room. The primary outcome will be number of symptomatic winter respiratory infection episodes. Secondary outcomes include specific clinical measures of infection, number of falls / near falls, number of laboratory confirmed infections, hospitalisations, staff sickness and cost-effectiveness. A mixed methods process evaluation will assess intervention acceptability and implementation. The results of AFRI-c will provide vital information about whether portable HEPA filtration units reduce symptomatic winter respiratory infections in older care home residents. Findings about effectiveness, fidelity, acceptability and cost-effectiveness will support stakeholders to determine the use of HEPA filtration units as part of infection control policies.

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Concepts	Keywords
Hospitalisations	Aged
Microbial	Air Filters
Ninety	COVID-19
Randomized	England
Winter	Humans
	Nursing Homes
	Respiratory Tract Infections
	SARS-CoV-2
	Seasons

Semantics

Type	Source	Name
drug	DRUGBANK	Medical air
disease	MESH	respiratory infections
disease	MESH	COVID-19
disease	VO	protocol
disease	VO	efficiency
disease	MESH	infections
disease	IDO	infection
disease	IDO	intervention
drug	DRUGBANK	Pentaerythritol tetranitrate
drug	DRUGBANK	Etoperidone
disease	VO	effectiveness
disease	IDO	process
disease	VO	population
disease	IDO	history
disease	IDO	blood
disease	VO	bodily fluid
disease	VO	frequency
disease	VO	effective
disease	IDO	symptom
disease	VO	vaccination
disease	IDO	bacteria
disease	VO	Viruses
disease	MESH	influenza
disease	VO	manufacturer
disease	IDO	host
drug	DRUGBANK	Corticorelin
drug	DRUGBANK	Glycine betaine
disease	MESH	dementia
disease	MESH	death
disease	MESH	delirium
pathway	KEGG	Influenza A
disease	VO	Respiratory syncytial virus
disease	VO	Metapneumovirus
disease	MESH	uncertainty
disease	VO	volume
disease	VO	time
disease	IDO	local infection
disease	VO	nose
drug	DRUGBANK	Trestolone
disease	VO	adverse event
disease	VO	document
disease	IDO	site
disease	VO	device
disease	MESH	emergency
drug	DRUGBANK	L-Valine
disease	VO	publication
disease	VO	monthly
drug	DRUGBANK	Ranitidine
disease	VO	Gap
drug	DRUGBANK	Honey
drug	DRUGBANK	Coenzyme M
drug	DRUGBANK	L-Phenylalanine
disease	IDO	facility
disease	MESH	loneliness
disease	MESH	Common cold

Original Article

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