Hospital-based caregiver intervention for people following hip fracture surgery (HIP HELPER): multi-centre randomised controlled feasibility trial with embedded qualitative study in England.

Toby O. Smith, Reema Khoury, Sarah Hanson, Allie Welsh, Kelly Grant, Allan B. Clark, Polly-Anna Ashford, Sally Hopewell, Klaus Pfeiffer, Pip A. Logan, Maria Crotty, Matthew L. Costa, Sallie Lamb, on behalf of the HIP HELPER Study Collaborators

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Abstract

Objectives To assess the feasibility of conducting a pragmatic, multicentre randomised controlled trial (RCT) to test the clinical and cost-effectiveness of an informal caregiver training programme to support the recovery of people following hip fracture surgery. Design Two-arm, multicentre, pragmatic, open, feasibility RCT with embedded qualitative study. Setting National Health Service (NHS) providers in five English hospitals. Participants Community-dwelling adults, aged 60 years and over, who undergo hip fracture surgery and their informal caregivers. Intervention Usual care: usual NHS care. Experimental: usual NHS care plus a caregiver-patient dyad training programme (HIP HELPER). This programme comprised three, 1 hour, one-to-one training sessions for a patient and caregiver, delivered by a nurse, physiotherapist or occupational therapist in the hospital setting predischarge. After discharge, patients and caregivers were supported through three telephone coaching sessions. Randomisation and blinding Central randomisation was computer generated (1:1), stratified by hospital and level of patient cognitive impairment. There was no blinding. Main outcome measures Data collected at baseline and 4 months post randomisation included: screening logs, intervention logs, fidelity checklists, acceptability data and clinical outcomes. Interviews were conducted with a subset of participants and health professionals. Results 102 participants were enrolled (51 patients; 51 caregivers). Thirty-nine per cent (515/1311) of patients screened were eligible. Eleven per cent (56/515) of eligible patients consented to be randomised. Forty-eight per cent (12/25) of the intervention group reached compliance to their allocated intervention. There was no evidence of treatment contamination. Qualitative data demonstrated the trial and HIP HELPER programme was acceptable. Conclusions The HIP HELPER programme was acceptable to patient-caregiver dyads and health professionals. The COVID-19 pandemic impacting on site's ability to deliver the research. Modifications are necessary to the design for a viable definitive RCT. Trial registration number ISRCTN13270387.

Original languageEnglish
Article numbere073611
JournalBMJ Open
Volume13
Issue number12
Early online date9 Dec 2023
DOIs
Publication statusPublished - Dec 2023

Keywords

  • trauma
  • femoral fracture
  • recovery
  • rehabilitation
  • domiciliary
  • carer
  • home network
  • RCT
  • rehabilitation medicine
  • nursing care
  • orthopaedic & trauma surgery
  • hip

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