Kylee J Lockwood1,2, Katherine E Harding1,2, Jude N Boyd3, Nicholas F Taylor1,2. 1. 1 School of Allied Health, La Trobe University, Melbourne, VIC, Australia. 2. 2 Allied Health Clinical Research Office, Eastern Health, Melbourne, VIC, Australia. 3. 3 Department of Occupational Therapy, Eastern Health, Melbourne, VIC, Australia.
Abstract
OBJECTIVE: : The objective of this study is to investigate whether home assessment visits prior to hospital discharge for patients recovering from hip fracture reduce falls and prevent hospital readmissions, within the first 30 days and six months after discharge home. DESIGN: : A randomized controlled trial was conducted. SETTING: : The study setting included hospital wards and the community. PARTICIPANTS:: The study included adults 50 years and over recovering from hip fracture ( n = 77). INTERVENTION:: Both groups received inpatient rehabilitation and hospital-based discharge planning. In addition, the intervention group received a home assessment visit by an occupational therapist prior to discharge from hospital. MAIN MEASURES:: Primary outcomes were falls and hospital readmissions. Secondary outcome measures included Functional Independence Measure, Functional Autonomy Measurement Scale, Nottingham Extended Activities of Daily Living Scale, EuroQol five dimension scale questionnaire and Falls Efficacy Scale-International. RESULTS: : The intervention group had fewer hospital readmissions in the first 30 days compared to the control group (intervention n = 1, control n = 10; odds ratio (OR) 12.9, 95% confidence interval (CI) 1.5 to 99.2). The intervention group was observed to have fewer falls than controls in the 30 days after discharge (intervention n = 6, control n = 14; incidence rate ratio (IRR) = 0.41, 95% CI 0.15 to 1.11). Between-group differences favoured the intervention group for functional independence at six months (11.2 units, 95% CI 4.2 to 18.2). There were no other between-group differences. CONCLUSION: : Home assessment visits by occupational therapists prior to hospital discharge for patients recovering from hip fracture reduced the number of readmissions to hospital, increased functional independence at six months and may have reduced the risk of falls in the first 30 days after discharge.
RCT Entities:
OBJECTIVE: : The objective of this study is to investigate whether home assessment visits prior to hospital discharge for patients recovering from hip fracture reduce falls and prevent hospital readmissions, within the first 30 days and six months after discharge home. DESIGN: : A randomized controlled trial was conducted. SETTING: : The study setting included hospital wards and the community. PARTICIPANTS:: The study included adults 50 years and over recovering from hip fracture ( n = 77). INTERVENTION:: Both groups received inpatient rehabilitation and hospital-based discharge planning. In addition, the intervention group received a home assessment visit by an occupational therapist prior to discharge from hospital. MAIN MEASURES:: Primary outcomes were falls and hospital readmissions. Secondary outcome measures included Functional Independence Measure, Functional Autonomy Measurement Scale, Nottingham Extended Activities of Daily Living Scale, EuroQol five dimension scale questionnaire and Falls Efficacy Scale-International. RESULTS: : The intervention group had fewer hospital readmissions in the first 30 days compared to the control group (intervention n = 1, control n = 10; odds ratio (OR) 12.9, 95% confidence interval (CI) 1.5 to 99.2). The intervention group was observed to have fewer falls than controls in the 30 days after discharge (intervention n = 6, control n = 14; incidence rate ratio (IRR) = 0.41, 95% CI 0.15 to 1.11). Between-group differences favoured the intervention group for functional independence at six months (11.2 units, 95% CI 4.2 to 18.2). There were no other between-group differences. CONCLUSION: : Home assessment visits by occupational therapists prior to hospital discharge for patients recovering from hip fracture reduced the number of readmissions to hospital, increased functional independence at six months and may have reduced the risk of falls in the first 30 days after discharge.
Entities:
Keywords:
Occupational therapy; discharge planning; falls; home visit; readmission
Authors: Antonio De Vincentis; Astrid Ursula Behr; Giuseppe Bellelli; Marco Bravi; Anna Castaldo; Lucia Galluzzo; Giovanni Iolascon; Stefania Maggi; Emilio Martini; Alberto Momoli; Graziano Onder; Marco Paoletta; Luca Pietrogrande; Mauro Roselli; Mauro Ruggeri; Carmelinda Ruggiero; Fabio Santacaterina; Luigi Tritapepe; Amedeo Zurlo; Raffaele Antonelli Incalzi Journal: Aging Clin Exp Res Date: 2021-07-21 Impact factor: 3.636