The REFRESH trial

nutRition intervEntions For malnouRished oldEr adultS in care Homes: a parallel, superiority, three-arm cluster randomised controlled trial

Female cook serving food to a group of seniors in a nursing home

The REFRESH trial

nutRition intervEntions For malnouRished oldEr adultS in care Homes: a parallel, superiority, three-arm cluster randomised controlled trial

Care home managers: join the study

We are looking for care homes in or close to Devon, Dorset, Hampshire, Bath, Bristol and the West Midlands to participate in this study.

Find out more and register your interest

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 GP and hospital appointments, and experience slow recovery from illness. Treating malnutrition costs a huge amount; estimated at over £11 billion a year in health and social care. Some of this money is spent on prescribing oral nutritional supplements (drinks containing a balance of energy, protein, vitamins and minerals).

REFRESH aims to test the most effective ways to treat malnutrition in older care home residents. We will recruit 90 care homes and 1,530 residents at risk of malnutrition. Each care home will be randomly put into one group, and its residents will receive this approach to treating any malnutrition:

Oral nutritional supplements
Fortified food and drink
Routine practice (treatment as usual)

We will collect information from residents at the start of the study, and then at six and 12 months, including quality of life, food intake, appetite, weight, activities of daily living, and the use of NHS services.

Those who often do not have the opportunity to participate in research – for example, those from ethnic minority groups and those who depend on others to make their decisions – will be included.

Study updates

Research Ethics Committee approval was received on 07/10/2025
Our first care home site opened on 28/11/2025

Newsletter

REFRESH newsletter – October 2025

REFRESH newsletter – July 2025

The team

Miss Hanna Abraham

Data Manager
Professor Victoria Allgar

Professor of Medical Statistics and Director of PenCTU
Dr Paigan Aspinall

Clinical Trials Data Management and Information Systems Manager
Dr Katherine Beaney

PenCTU Trial Manager
Professor Richard Byng

Professor in Primary Care Research/PenARC Deputy Director
Dr Jade Chynoweth

Research Fellow in Medical Statistics
Professor Mary Hickson

Professor in Dietetics
Dr Joanne Hosking

Senior Research Fellow & BMBS Lead for Statistics & Numeracy
Dr Esther Muriuki

Senior Research Fellow
Dr Helen Neilens

PenCTU Senior Trial Manager
Dr Chris Rollinson

Quality Assurance Manager
Miss Emily Stanyard

PenCTU Trial Manager
Mr Elis Wilson

Research Assistant in Medical Statistics