The feasibility of conducting a randomised controlled trial of the effectiveness of home visits by occupational therapists after hip fracture

Ms Kylee Lockwood1,2, Professor Nicholas Taylor1,2, Ms Jude Boyd2, Dr  Katherine Harding1,2

1La Trobe University, Melbourne, Australia, 2Eastern Health, Melbourne, Australia

Aim

To examine the feasibility of conducting a randomised controlled trial of the effectiveness of pre-discharge home visits by occupational therapists in patients after hip fracture.

Method

The planning and implementation of a randomised controlled trial was explored within a feasibility framework. The key areas explored included: acceptability, demand, implementation, practicality, adaptation, integration, expansion and efficacy. Consideration was given to the potential ethical dilemma associated with the withdrawal of such an established and accepted intervention for those allocated to the control group.

Results

The trial aimed to recruit 74 participants and was supported by a small grant. There were high levels of acceptability from clinicians and patients including those allocated to the control group. There was a demonstrated demand with recruitment completed within 6 months. The trial was successfully implemented over a large geographical area and practicality was demonstrated with over 95% of home visits completed before discharge. The trial adapted usual practice by building in formal evaluation and follow-up, and the process was well integrated into the health service. Data on efficacy will be presented and the potential for expansion evaluated with economic evaluation.

Significance of the findings to allied health

It was feasible to conduct a randomised controlled trial of home visits after hip fracture in a large health service. Key to the feasibility was resources and planning put into the project.The feasibility of studying this intervention needed to be evaluated as evidence-based practice is important in the delivery of health care.