Background: Many people with COPD also live with frailty and are at increased risk of poorer health and outcomes. This group struggle to complete pulmonary rehabilitation. Integrated approaches adapted for frailty are required.

Aim: To determine the feasibility of conducting a RCT of an integrated Comprehensive Geriatric Assessment (CGA) for people with COPD and frailty starting pulmonary rehabilitation.

Methods: Multicentre mixed-methods feasibility RCT. Eligible participants were aged ?50 with both COPD and frailty (Clinical Frailty Scale ?5) referred for pulmonary rehabilitation. Participants were randomised 1:1 to usual pulmonary rehabilitation, or pulmonary rehabilitation plus a CGA. Outcomes (physical, psycho-social, service use) were measured at baseline, 90 and 180 days, alongside process data and qualitative interviews.

Results: Recruitment was stopped at 31 participants (mean age 72.4 [SD 10.1], 61% male, 68% MRC 4-5) following COVID-19-related disruptions. Recruitment (47% eligible recruited) and retention (87% at both 90- and 180-day follow-up) were acceptable. CGAs prompted 46 individual care recommendations (median 3 per participant, range 0-12). Most common types of recommendation were for medication and onward referral, and the most common domains addressed included nutrition and cardiovascular health. During the study period, 65% of recommendations were implemented. The trial methods and intervention were acceptable; participants particularly valued the holistic approach of CGA.

Conclusion: CGA and resulting recommendations can successfully be delivered to this population, and a RCT to test effectiveness is feasible and acceptable.