Development of an evidence-based complex intervention for community rehabilitation of patients with hip fracture using realist review, survey and focus groups

Jessica Louise Roberts; Nafees Ud Din; Michelle Williams; Claire Hawkes; Joanna  Charles; Zoe Hoare; Val Morrison; Swapna Alexander; Andrew Lemmey; Catherine Sackley; Phillipa Logan; Clare Wilkinson; Jo Rycroft-Malone; Nefyn  Williams

doi:10.1136/bmjopen-2016-014362

Development of an evidence-based complex intervention for community rehabilitation of patients with hip fracture using realist review, survey and focus groups

Jessica Louise Roberts
, Nafees Ud Din
, Michelle Williams
, Claire Hawkes
, Joanna Charles
, Zoe Hoare
, Val Morrison
, Swapna Alexander
, Andrew Lemmey
, Catherine Sackley
, Phillipa Logan
, Clare Wilkinson
, Jo Rycroft-Malone
, Nefyn Williams

University of Warwick
Betsi Cadwaladr University Health Board
King's College London
University of Nottingham

Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid

238 Wedi eu Llwytho i Lawr (Pure)

Crynodeb

OBJECTIVES: To develop an evidence and theory-based complex intervention for improving outcomes in elderly patients following hip fracture.

DESIGN: Complex-intervention development (Medical Research Council (MRC) framework phase I) using realist literature review, surveys and focus groups of patients and rehabilitation teams.

SETTING: North Wales.

PARTICIPANTS: Surveys of therapy managers (n=13), community and hospital-based physiotherapists (n=129) and occupational therapists (n=68) throughout the UK. Focus groups with patients (n=13), their carers (n=4) and members of the multidisciplinary rehabilitation teams in North Wales (n=13).

RESULTS: The realist review provided understanding of how rehabilitation interventions work in the real-world context and three programme theories were developed: improving patient engagement by tailoring the intervention to individual needs; reducing fear of falling and improving self-efficacy to exercise and perform activities of daily living; and coordination of rehabilitation delivery. The survey provided context about usual rehabilitation practice; focus groups provided data on the experience, acceptability and feasibility of rehabilitation interventions. An intervention to enhance usual rehabilitation was developed to target these theory areas comprising: a physical component consisting of six additional therapy sessions; and a psychological component consisting of a workbook to enhance self-efficacy and a patient-held goal-setting diary for self-monitoring.

CONCLUSIONS: A realist approach may have advantages in the development of evidence-based interventions and can be used in conjunction with other established methods to contribute to the development of potentially more effective interventions. A rehabilitation intervention was developed which can be tested in a future randomised controlled trial (MRC framework phases II and III).

TRIAL REGISTRATION NUMBER: ISRCTN22464643, Pre-results.

Iaith wreiddiol	Saesneg
Rhif yr erthygl	e014362
Cyfnodolyn	BMJ Open
Cyfrol	7
Rhif cyhoeddi	10
Dynodwyr Gwrthrych Digidol (DOIs)	https://doi.org/10.1136/bmjopen-2016-014362
Statws	Cyhoeddwyd - 11 Hyd 2017

Mynediad at Ddogfen

10.1136/bmjopen-2016-014362

2017 FEMuR phase I develop interventionFersiwn derfynol wedi’i chyhoeddi, 991 KB

FEMuR (Fracture in the Elderly Multidisciplinary Rehabilitation)
1/11/12 → 15/08/18
Project: Ymchwil

Developing a multidisciplinary rehabilitation package following hip fracture and testing in a randomised feasibility study: Fracture in the Elderly Multidisciplinary Rehabilitation (FEMuR)
Williams, N., Roberts, J., Din, N., Charles, J., Totton, N., Williams, M., Mawdesley, K., Hawkes, C., Morrison, V., Lemmey, A., Edwards, R., Hoare, Z., Pritchard, A., Woods, R., Alexander, S., Sackley, C., Logan, P., Wilkinson, C. & Rycroft-Malone, J., Awst 2017, Health Technology Assessment, 21, 44.
Allbwn ymchwil: Cyfraniad at gyhoeddiad arbenigol › Erthygl

Mynediad agored
Ffeil
467 Wedi eu Llwytho i Lawr (Pure)
Fracture in the Elderly Multidisciplinary Rehabilitation (FEMuR): study protocol for a phase II randomised feasibility study of a multidisciplinary rehabilitation package following hip fracture [ ISRCTN22464643 ]
Williams, N. H., Hawkes, C. A., Din, N. U., Roberts, J. L., Charles, J. M., Morrison, V. L., Hoare, Z. S., Edwards, R. T., Alexander, S., Andrew, G., Lemmey, A. B., Woods, R. T., Sackley, C., Logan, P., Hunnisett, D. S., Mawdesley, K. J. & Wilkinson, C. E., 7 Ebr 2015, Yn: Pilot and Feasibility Studies. 1, 13, t. 1-22
Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid

Mynediad agored
Ffeil

300 Wedi eu Llwytho i Lawr (Pure)

Dyfynnu hyn

Roberts, J. L., Din, N. U., Williams, M., Hawkes, C., Charles, J., Hoare, Z., Morrison, V., Alexander, S., Lemmey, A., Sackley, C., Logan, P., Wilkinson, C., Rycroft-Malone, J., & Williams, N. (2017). Development of an evidence-based complex intervention for community rehabilitation of patients with hip fracture using realist review, survey and focus groups. BMJ Open, 7(10), erthygl e014362. https://doi.org/10.1136/bmjopen-2016-014362

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title = "Development of an evidence-based complex intervention for community rehabilitation of patients with hip fracture using realist review, survey and focus groups",

abstract = "OBJECTIVES: To develop an evidence and theory-based complex intervention for improving outcomes in elderly patients following hip fracture.DESIGN: Complex-intervention development (Medical Research Council (MRC) framework phase I) using realist literature review, surveys and focus groups of patients and rehabilitation teams.SETTING: North Wales.PARTICIPANTS: Surveys of therapy managers (n=13), community and hospital-based physiotherapists (n=129) and occupational therapists (n=68) throughout the UK. Focus groups with patients (n=13), their carers (n=4) and members of the multidisciplinary rehabilitation teams in North Wales (n=13).RESULTS: The realist review provided understanding of how rehabilitation interventions work in the real-world context and three programme theories were developed: improving patient engagement by tailoring the intervention to individual needs; reducing fear of falling and improving self-efficacy to exercise and perform activities of daily living; and coordination of rehabilitation delivery. The survey provided context about usual rehabilitation practice; focus groups provided data on the experience, acceptability and feasibility of rehabilitation interventions. An intervention to enhance usual rehabilitation was developed to target these theory areas comprising: a physical component consisting of six additional therapy sessions; and a psychological component consisting of a workbook to enhance self-efficacy and a patient-held goal-setting diary for self-monitoring.CONCLUSIONS: A realist approach may have advantages in the development of evidence-based interventions and can be used in conjunction with other established methods to contribute to the development of potentially more effective interventions. A rehabilitation intervention was developed which can be tested in a future randomised controlled trial (MRC framework phases II and III).TRIAL REGISTRATION NUMBER: ISRCTN22464643, Pre-results.",

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author = "Roberts, \{Jessica Louise\} and Din, \{Nafees Ud\} and Michelle Williams and Claire Hawkes and Joanna Charles and Zoe Hoare and Val Morrison and Swapna Alexander and Andrew Lemmey and Catherine Sackley and Phillipa Logan and Clare Wilkinson and Jo Rycroft-Malone and Nefyn Williams",

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Roberts, JL, Din, NU, Williams, M, Hawkes, C, Charles, J, Hoare, Z, Morrison, V, Alexander, S, Lemmey, A, Sackley, C, Logan, P, Wilkinson, C, Rycroft-Malone, J & Williams, N 2017, 'Development of an evidence-based complex intervention for community rehabilitation of patients with hip fracture using realist review, survey and focus groups', BMJ Open, cyfrol. 7, rhif 10, e014362. https://doi.org/10.1136/bmjopen-2016-014362

TY - JOUR

T1 - Development of an evidence-based complex intervention for community rehabilitation of patients with hip fracture using realist review, survey and focus groups

AU - Roberts, Jessica Louise

AU - Din, Nafees Ud

AU - Williams, Michelle

AU - Hawkes, Claire

AU - Charles, Joanna

AU - Hoare, Zoe

AU - Morrison, Val

AU - Alexander, Swapna

AU - Lemmey, Andrew

AU - Sackley, Catherine

AU - Logan, Phillipa

AU - Wilkinson, Clare

AU - Rycroft-Malone, Jo

AU - Williams, Nefyn

PY - 2017/10/11

Y1 - 2017/10/11

N2 - OBJECTIVES: To develop an evidence and theory-based complex intervention for improving outcomes in elderly patients following hip fracture.DESIGN: Complex-intervention development (Medical Research Council (MRC) framework phase I) using realist literature review, surveys and focus groups of patients and rehabilitation teams.SETTING: North Wales.PARTICIPANTS: Surveys of therapy managers (n=13), community and hospital-based physiotherapists (n=129) and occupational therapists (n=68) throughout the UK. Focus groups with patients (n=13), their carers (n=4) and members of the multidisciplinary rehabilitation teams in North Wales (n=13).RESULTS: The realist review provided understanding of how rehabilitation interventions work in the real-world context and three programme theories were developed: improving patient engagement by tailoring the intervention to individual needs; reducing fear of falling and improving self-efficacy to exercise and perform activities of daily living; and coordination of rehabilitation delivery. The survey provided context about usual rehabilitation practice; focus groups provided data on the experience, acceptability and feasibility of rehabilitation interventions. An intervention to enhance usual rehabilitation was developed to target these theory areas comprising: a physical component consisting of six additional therapy sessions; and a psychological component consisting of a workbook to enhance self-efficacy and a patient-held goal-setting diary for self-monitoring.CONCLUSIONS: A realist approach may have advantages in the development of evidence-based interventions and can be used in conjunction with other established methods to contribute to the development of potentially more effective interventions. A rehabilitation intervention was developed which can be tested in a future randomised controlled trial (MRC framework phases II and III).TRIAL REGISTRATION NUMBER: ISRCTN22464643, Pre-results.

AB - OBJECTIVES: To develop an evidence and theory-based complex intervention for improving outcomes in elderly patients following hip fracture.DESIGN: Complex-intervention development (Medical Research Council (MRC) framework phase I) using realist literature review, surveys and focus groups of patients and rehabilitation teams.SETTING: North Wales.PARTICIPANTS: Surveys of therapy managers (n=13), community and hospital-based physiotherapists (n=129) and occupational therapists (n=68) throughout the UK. Focus groups with patients (n=13), their carers (n=4) and members of the multidisciplinary rehabilitation teams in North Wales (n=13).RESULTS: The realist review provided understanding of how rehabilitation interventions work in the real-world context and three programme theories were developed: improving patient engagement by tailoring the intervention to individual needs; reducing fear of falling and improving self-efficacy to exercise and perform activities of daily living; and coordination of rehabilitation delivery. The survey provided context about usual rehabilitation practice; focus groups provided data on the experience, acceptability and feasibility of rehabilitation interventions. An intervention to enhance usual rehabilitation was developed to target these theory areas comprising: a physical component consisting of six additional therapy sessions; and a psychological component consisting of a workbook to enhance self-efficacy and a patient-held goal-setting diary for self-monitoring.CONCLUSIONS: A realist approach may have advantages in the development of evidence-based interventions and can be used in conjunction with other established methods to contribute to the development of potentially more effective interventions. A rehabilitation intervention was developed which can be tested in a future randomised controlled trial (MRC framework phases II and III).TRIAL REGISTRATION NUMBER: ISRCTN22464643, Pre-results.

KW - Journal Article

U2 - 10.1136/bmjopen-2016-014362

DO - 10.1136/bmjopen-2016-014362

M3 - Article

C2 - 29025824

SN - 2044-6055

VL - 7

JO - BMJ Open

JF - BMJ Open

IS - 10

M1 - e014362

ER -

Development of an evidence-based complex intervention for community rehabilitation of patients with hip fracture using realist review, survey and focus groups

Crynodeb

Mynediad at Ddogfen

Ôl bys

Prosiectau

FEMuR (Fracture in the Elderly Multidisciplinary Rehabilitation)

Allbwn Ymchwil

Developing a multidisciplinary rehabilitation package following hip fracture and testing in a randomised feasibility study: Fracture in the Elderly Multidisciplinary Rehabilitation (FEMuR)

Fracture in the Elderly Multidisciplinary Rehabilitation (FEMuR): study protocol for a phase II randomised feasibility study of a multidisciplinary rehabilitation package following hip fracture [ ISRCTN22464643 ]

Dyfynnu hyn