Post-acute Care for Patients With Hip Fracture

NCT ID: NCT04287101

Last Updated: 2022-07-05

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 41 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2020-03-02
• Study Completion Date: 2021-12-31

Brief Summary

Background and purpose: Hip fracture, a common injury occurred in people aged over 50, may result in disability, poor quality of life, and higher care stress for their families. Aging population and growing number of hip fractures have increased medical expenses, so developed countries implemented post-acute care (PAC) to reduce acute hospitalization, and to improve the quality of care. PAC services can be delivered by hospital/facility-based and home-based services. Previous studies showed that both services could significantly improve patients' activities of daily living and quality of life, and reduce readmissions, long-term care and costs. Taiwan has implemented PAC plan for hip fractures since 2017, but relevant evidences are limited. Therefore, the purpose of this study is to analyze the efficacy and cost-effectiveness of PAC for patients with hip fractures.

Detailed Description

Methods: This is a prospective cohort study which will recruit patients aged over 50 with hip fractures receiving surgical treatment in the Taipei City Hospital. They will be provided home-based PAC, hospital-based PAC, or no formal PAC based on the medical judgment and patients/families' willingness. The period of PAC will be two to three weeks after the acute hospitalization. Assessments include physical function (30 seconds sit to stand, Barthel index, and Harris Hip Score), numerical pain rating scale, EuroQol instrument (EQ-5D), Caregiver Strain Index, and using of medical resources. The assessments will be on the day before discharge from acute hospitalization, and on the discharge day from post-acute care. The follow-up assessment will be at 1, 3, 6, and 12 months after operation. The cost-effectiveness ratio will be defined as the New Taiwan dollars paid for 1-unit improvement of functional performance and quality of life.

Conditions

Hip Fractures; Activities of Daily Living

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

home PAC

A home PAC team will care for patients in his/her home within 3 weeks after acute hospitalization. The patient will get a physical therapy (PT) or occupational therapy (OT) 1 to 6 session(s) per week.

Group Type: EXPERIMENTAL

Post-operative PT and OT

Intervention Type: OTHER

Strengthening exercise, range-of-motion exercise, functional training, balance training, adjustment for assistive devices, adaptation and modification of the home environment, and patient/caregiver education

hospital PAC

A rehabilitation PAC team will care for patients in the hospital within 3 weeks after acute hospitalization. The patient will have 1 to 2 session(s) of PT or OT on weekdays, and a daily physician visit and nurse care.

Group Type: ACTIVE_COMPARATOR

Post-operative PT and OT

Intervention Type: OTHER

Strengthening exercise, range-of-motion exercise, functional training, balance training, adjustment for assistive devices, adaptation and modification of the home environment, and patient/caregiver education

conventional care group

usual care

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Post-operative PT and OT

Strengthening exercise, range-of-motion exercise, functional training, balance training, adjustment for assistive devices, adaptation and modification of the home environment, and patient/caregiver education

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

1. Aged ≥ 50

2. First hip fracture

3. Stable medical condition

Exclusion Criteria

1. Hip fracture caused by major trauma or pathological condition

2. Multiple fractures

3. Severe physical disability before the hip fracture

4. Unable to cooperate with treatment

5. Further inpatient treatment

• Minimum Eligible Age: 50 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Taipei City Hospital

OTHER_GOV

Sponsor Role: lead

Responsible Party

Shih-Liang Shih

Director of Orthopedics

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Shih-Liang Shih, PhD.

Role: PRINCIPAL_INVESTIGATOR

Department of Orthopaedic, Taipei City Hospital, Zhongxing Branch

Locations

Taipei City Hospital

Taipei, , Taiwan

Countries

Taiwan

Other Identifiers

PAC for hip fracture

Identifier Type: -

Identifier Source: org_study_id