Abstract
Objectives
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.
Design
This is a parallel 1:1 randomized controlled feasibility study.
Setting
The study was conducted in a teaching hospital in Vancouver, BC, Canada.
Participants
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
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.
Measurement
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).
Results
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.
Conclusion
We highlight the feasibility of telephone coaching for older adults after hip fracture to improve adherence to mobility recovery goals.
Video abstract
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Acknowledgments
The authors extend sincere thanks to study participants for their generosity with their time, and the staff of the hospital unit where the study took place. The authors also thank Dr Pierre Guy for his support and advice, Mr Joseph Puyat for his assistance with study design and data analyses, research assistants Samantha Gray and Megan McAllister, and Chantalle Jack, librarian at Vancouver Coastal Health for assistance retrieving papers for the literature review. The authors gratefully acknowledge financial support from the Vancouver Coastal Health Research Institute/North Shore Health Research Foundation, North Vancouver (F13-02469), the Vancouver General Hospital Foundation, and the University of British Columbia Foundation, and career award support to Dr Ashe from the Canadian Institutes of Health Research and the Michael Smith Foundation for Health Research. The sponsors had no role in the study design, analysis, or preparation of this manuscript.
Author contributions
Authors DPL and MCA contributed to the study concept and design. DPL, KCB, MF, ML, JL, and KP contributed to the acquisition of subjects and/or data. All authors contributed to the analysis and interpretation of data, and took part in either drafting or revising the manuscript.
Disclosure
The authors have no conflicts of interest to disclose.