Patient and caregiver outcomes 12 months after home-based therapy for hip fracture: a randomized controlled trial.
OBJECTIVE
To compare the effect of early discharge and home-based therapy with conventional hospital rehabilitation on patient and caregiver outcomes at 12 months after hip fracture.


METHODS
Randomized controlled trial.


METHODS
Acute and subacute care with follow-up in a community setting in Australia.


METHODS
Sixty-six older adults admitted to acute care after hip fracture who were assessed as needing rehabilitation.


METHODS
Eligible patients were randomized to either home-based (n=34) or hospital (n=32) rehabilitation. Patients assigned to the home-based group were discharged home within 48 hours of randomization. Patients assigned to hospital rehabilitation received usual care.


METHODS
Modified Barthel Index (MBI), timed up and go (TUG) test, Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and Caregiver Strain Index.


RESULTS
At 12 months, 56 of 66 (85%) participants were available for follow-up assessment. Both groups achieved significant improvements in MBI and TUG test scores. Patients in both groups had a significant decline in the physical score of the SF-36 and there were no differences between groups. Caregivers of patients allocated to receive home-based therapy reported a reduction in burden after 12 months. Over that period, there was a significant reduction in the burden for caregivers of those patients who received home rehabilitation (P=.020).


CONCLUSIONS
For patients who were previously functionally independent and living in the community, early return home with increased involvement of caregivers after hip fracture resulted in similar patient outcomes (home vs hospital) and less caregiver burden at 12 months.
Crotty
Maria
M
Southern Regional Department of Rehabilitation and Aged Care, Repatriation General Hospital, Daw Park, Australia. maria.crotty@flinders.edu.au
Whitehead
Craig
C
Miller
Michelle
M
Gray
Stephen
S
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003625:Data Collection; D005260:Female; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006620:Hip Fractures / Q000453:epidemiology* / Q000534:rehabilitation*; D018575:Home Care Services, Hospital-Based / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data; D015397:Program Evaluation; D011446:Prospective Studies; D020127:Recovery of Function; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric; D016896:Treatment Outcome