None listed
Conditions
Interventions
The control group receives care as usual, as embedded in the care pathway geriatric rehabilitation for hip fracture patients. The intervention group receives the FIT-HIP intervention integrated in the
Sponsors
Leiden University Medical Center (LUMC)
Department of Public Health and Primary Care (PHEG)
Eligibility
Inclusion criteria
Inclusion criteria: Main inclusion criteria: - Aged 65 years or older - Admitted to a geriatric rehabilitation (GR) unit for rehabilitation due to a hip fracture - Concerned to fall. This is measured by the one item fear of falling question (answering ‘positively’ in the category sometimes, often or very often)
Exclusion criteria
Exclusion criteria: - The patient has a condition interfering with learning ability, such as: 1. A diagnosis of dementia or score on the 'hetero-anamnesis list cognition' > 1, suggesting pre-morbid cognitive problems 2. A major psychiatric disease 3. Insufficient mastery of Dutch language - The patient has a limited life expectancy - The patient has a pathological hip fracture - Pre-fracture Barthel-index score < 15 (as a measure of ADL dependency)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1.Mean difference in The Tinetti Performance Oriented Mobility Assessment (POMA) score at discharge from GR (or at a maximum of 3 months of admittance to GR), compared between FIT-HIP intervention and usual care. The POMA is a measure of mobility function (gait and balance). 2. Mean difference in the Falls Efficacy Scale International (FES-I) score at discharge from GR (or at a maximum of 3 months of admittance to GR), compared between FIT-HIP intervention and usual care. The FES-I is a measure of fear of falling. | — |
Secondary
| Measure | Time frame |
|---|---|
| A. Effect evaluation: Mean differences for the following parameters at discharge from GR will be compared between FIT-HIP intervention and usual care: 1. Functional status (Barthel index, Functional Ambulation Categories). Time points: discharge. Follow up 1 and 2 (Barthel index). 2. Quality of life (EuroQOL five dimensions questionnaire). Time points: discharge, follow up 1 and 2. Also the following parameters will be compared between FIT-HIP intervention and usual care: 3. Number of falls (Fall calendar). Time points: discharge, follow up 1 and 2. 4. Mortality rate. 5. Discharge destination after rehabilitation. Time point: discharge. (“Home” = living address prior to the fracture. Any other discharge destination is labelled as “other”) 6. Participation after discharge from GR (Utrechtse Schaal voor Evaluatie van Revalidatie – Participatie). Time points: follow up 1 and 2. B. Process evaluation In accordance with the theory of Saunders and using a mixed-method approach (self-administered questionnaire and qualitative group interviews), fidelity; completeness; exposure; satisfaction; reach; recruitment and context will be evaluated as part of the process evaluation. C. Economic evaluation The economic evaluation consists of a cost analysis and a cost-utility analysis, both with a six-month time horizon after discharge from GR. Costs will be measured from a healthcare perspective. In the cost-utility analysis, the difference in healthcare costs between the strategies will be compared to the difference in Quality-Adjusted Life Years (QALYs, calculated using the Dutch EQ-5D tariff and the visual analogue scale for health). Estimated healthcare costs will include the costs of the FIT-HIP intervention (estimated from the study registration) and other healthcare utilization (estimated using quarterly questionnaires filled out by the patients). Other healthcare utilization will include general practitioners, other consultations, home care, informal care, hos | — |
Contacts
Public ContactMaaike Scheffers-Barnhoorn
Postzone V0-P, (kamer V6-68), PO Box 9600, 2300 RC Leiden, The Netherlands
Outcome results
None listed