Langford Dolores P, Fleig Lena, Brown Kristin C, Cho Nancy J, Frost Maeve, Ledoyen Monique, Lehn Jayne, Panagiotopoulos Kostas, Sharpe Nina, Ashe Maureen C
Vancouver Coastal Health, The University of British Columbia (UBC), Vancouver, BC, Canada ; Department of Physical Therapy, The University of British Columbia (UBC), Vancouver, BC, Canada.
Department of Family Practice, The University of British Columbia (UBC), Vancouver, BC, Canada ; Centre for Hip Health and Mobility, Vancouver, BC, Canada ; Freie Universität Berlin, Health Psychology, Berlin, Germany.
Patient Prefer Adherence. 2015 Sep 22;9:1343-51. doi: 10.2147/PPA.S86922. eCollection 2015.
Our primary aim of this pilot study was to test feasibility of the planned design, the interventions (education plus telephone coaching), and the outcome measures, and to facilitate a power calculation for a future randomized controlled trial to improve adherence to recovery goals following hip fracture.
This is a parallel 1:1 randomized controlled feasibility study.
The study was conducted in a teaching hospital in Vancouver, BC, Canada.
Participants were community-dwelling adults over 60 years of age with a recent hip fracture. They were recruited and assessed in hospital, and then randomized after hospital discharge to the intervention or control group by a web-based randomization service. Treatment allocation was concealed to the investigators, measurement team, and data entry assistants and analysts. Participants and the research physiotherapist were aware of treatment allocation.
Intervention included usual care for hip fracture plus a 1-hour in-hospital educational session using a patient-centered educational manual and four videos, and up to five postdischarge telephone calls from a physiotherapist to provide recovery coaching. The control group received usual care plus a 1-hour in-hospital educational session using the educational manual and videos.
Our primary outcome was feasibility, specifically recruitment and retention of participants. We also collected selected health outcomes, including health-related quality of life (EQ5D-5L), gait speed, and psychosocial factors (ICEpop CAPability measure for Older people and the Hospital Anxiety and Depression Scale).
Our pilot study results indicate that it is feasible to recruit, retain, and provide follow-up telephone coaching to older adults after hip fracture. We enrolled 30 older adults (mean age 81.5 years; range 61-97 years), representing a 42% recruitment rate. Participants excluded were those who were not community dwelling on admission, were discharged to a residential care facility, had physician-diagnosed dementia, and/or had medical contraindications to participation. There were 27 participants who completed the study: eleven in the intervention group, 15 in the control group, and one participant completed a qualitative interview only. There were no differences between groups for health measures.
We highlight the feasibility of telephone coaching for older adults after hip fracture to improve adherence to mobility recovery goals.
本试点研究的主要目的是测试计划设计、干预措施(教育加电话指导)和结局指标的可行性,并为未来一项旨在提高髋部骨折后康复目标依从性的随机对照试验进行样本量计算。
这是一项1:1平行随机对照可行性研究。
该研究在加拿大不列颠哥伦比亚省温哥华的一家教学医院进行。
参与者为60岁以上近期发生髋部骨折的社区居住成年人。他们在医院招募和评估,出院后通过基于网络的随机服务随机分为干预组或对照组。治疗分配对研究者、测量团队、数据录入助手和分析师保密。参与者和研究物理治疗师知晓治疗分配情况。
干预措施包括髋部骨折的常规护理,以及使用以患者为中心的教育手册和四段视频进行1小时的院内教育课程,还有物理治疗师最多进行五次出院后电话随访以提供康复指导。对照组接受常规护理加使用教育手册和视频进行1小时的院内教育课程。
我们的主要结局是可行性,具体而言是参与者的招募和留存情况。我们还收集了选定的健康结局指标,包括健康相关生活质量(EQ5D - 5L)、步速以及心理社会因素(老年人ICEpop CAPability量表和医院焦虑抑郁量表)。
我们的试点研究结果表明,对髋部骨折后的老年人进行招募、留存并提供随访电话指导是可行的。我们招募了30名老年人(平均年龄81.5岁;范围61 - 97岁),招募率为42%。被排除的参与者是那些入院时不住在社区、出院后入住寄宿护理机构、有医生诊断的痴呆症和/或有参与医学禁忌的人。有27名参与者完成了研究:干预组11名,对照组15名,还有1名参与者仅完成了定性访谈。两组在健康指标方面没有差异。
我们强调了对髋部骨折后的老年人进行电话指导以提高对活动能力恢复目标依从性的可行性。