Jane Wu1, Steven G Faux1, John Estell2, Stephen Wilson3, Ian Harris4, Christopher J Poulos5, Linda Klein6. 1. 1 St. Vincent's Hospital, Sacred Heart Rehabilitation Service, Sydney, Australia. 2. 2 St. George Hospital, Department of Rehabilitation Medicine, Kogarah, Australia. 3. 3 Royal North Shore Hospital, Department of Rehabilitation Medicine, Australia. 4. 4 Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW, Australia. 5. 5 School of Public Health and Community Medicine, University of New South Wales, Clinics, NSW, Australia. 6. 6 Assessment & Evaluation Unit, Office of Medical Education (OME), The University of Sydney, NSW, Australia.
Abstract
OBJECTIVE: To investigate the impact of an in-reach rehabilitation team for patients admitted after road trauma. DESIGN: Randomised control trial of usual care versus early involvement of in-reach rehabilitation team. Telephone follow-up was conducted by a blind assessor at three months for those with minor/moderate injuries and six months for serious/severe injuries. SETTING:Four participating trauma services in New South Wales, Australia. SUBJECTS: A total of 214 patients admitted during 2012-2015 with a length of stay of at least five days. INTERVENTION: Provision of rehabilitation services in parallel with ward based therapy using an in-reach team for the intervention group. The control group could still access the ward based therapy (usual care). MAIN MEASURES: The primary outcome was acute length of stay. Secondary outcomes included percentage requiring inpatient rehabilitation, function (Functional Independence Measure and Timed Up and Go Test), psychological status (Depression Anxiety and Stress Score 21), pain (Orebro Musculoskeletal Pain Questionnaire) and quality of life (Short Form-12 v2). RESULTS:Median length of stay in acute care was 13 days (IQR 8-21). The intervention group, compared to the control group, received more physiotherapy and occupational therapy sessions (median number of sessions 16.0 versus 11.5, P=0.003). However, acute length of stay did not differ between the intervention and control groups (median 15 vs 12 days, P=0.37). There were no significant differences observed in the secondary outcomes at hospital discharge and follow-up. CONCLUSION: No additional benefit was found from the routine use of acute rehabilitation teams for trauma patients over and above usual care.
RCT Entities:
OBJECTIVE: To investigate the impact of an in-reach rehabilitation team for patients admitted after road trauma. DESIGN: Randomised control trial of usual care versus early involvement of in-reach rehabilitation team. Telephone follow-up was conducted by a blind assessor at three months for those with minor/moderate injuries and six months for serious/severe injuries. SETTING: Four participating trauma services in New South Wales, Australia. SUBJECTS: A total of 214 patients admitted during 2012-2015 with a length of stay of at least five days. INTERVENTION: Provision of rehabilitation services in parallel with ward based therapy using an in-reach team for the intervention group. The control group could still access the ward based therapy (usual care). MAIN MEASURES: The primary outcome was acute length of stay. Secondary outcomes included percentage requiring inpatient rehabilitation, function (Functional Independence Measure and Timed Up and Go Test), psychological status (Depression Anxiety and Stress Score 21), pain (Orebro Musculoskeletal Pain Questionnaire) and quality of life (Short Form-12 v2). RESULTS: Median length of stay in acute care was 13 days (IQR 8-21). The intervention group, compared to the control group, received more physiotherapy and occupational therapy sessions (median number of sessions 16.0 versus 11.5, P=0.003). However, acute length of stay did not differ between the intervention and control groups (median 15 vs 12 days, P=0.37). There were no significant differences observed in the secondary outcomes at hospital discharge and follow-up. CONCLUSION: No additional benefit was found from the routine use of acute rehabilitation teams for traumapatients over and above usual care.
Authors: Alice Coffey; Patricia Leahy-Warren; Eileen Savage; Josephine Hegarty; Nicola Cornally; Mary Rose Day; Laura Sahm; Kieran O'Connor; Jane O'Doherty; Aaron Liew; Duygu Sezgin; Rónán O'Caoimh Journal: Int J Environ Res Public Health Date: 2019-07-10 Impact factor: 3.390