- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04287101
Post-acute Care for Patients With Hip Fracture
June 30, 2022 updated by: Shih-Liang Shih, Taipei City Hospital
Home-Based Integrated Post-Acute Care Program for Hip Fracture
Background and purpose: Hip fracture, a common injury occurred in people aged over 50, may result in disability, poor quality of life, and higher care stress for their families.
Aging population and growing number of hip fractures have increased medical expenses, so developed countries implemented post-acute care (PAC) to reduce acute hospitalization, and to improve the quality of care.
PAC services can be delivered by hospital/facility-based and home-based services.
Previous studies showed that both services could significantly improve patients' activities of daily living and quality of life, and reduce readmissions, long-term care and costs.
Taiwan has implemented PAC plan for hip fractures since 2017, but relevant evidences are limited.
Therefore, the purpose of this study is to analyze the efficacy and cost-effectiveness of PAC for patients with hip fractures.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Methods: This is a prospective cohort study which will recruit patients aged over 50 with hip fractures receiving surgical treatment in the Taipei City Hospital.
They will be provided home-based PAC, hospital-based PAC, or no formal PAC based on the medical judgment and patients/families' willingness.
The period of PAC will be two to three weeks after the acute hospitalization.
Assessments include physical function (30 seconds sit to stand, Barthel index, and Harris Hip Score), numerical pain rating scale, EuroQol instrument (EQ-5D), Caregiver Strain Index, and using of medical resources.
The assessments will be on the day before discharge from acute hospitalization, and on the discharge day from post-acute care.
The follow-up assessment will be at 1, 3, 6, and 12 months after operation.
The cost-effectiveness ratio will be defined as the New Taiwan dollars paid for 1-unit improvement of functional performance and quality of life.
Study Type
Interventional
Enrollment (Actual)
41
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
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Taipei, Taiwan
- Taipei City Hospital
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
50 years and older (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Aged ≥ 50
- First hip fracture
- Stable medical condition
Exclusion Criteria:
- Hip fracture caused by major trauma or pathological condition
- Multiple fractures
- Severe physical disability before the hip fracture
- Unable to cooperate with treatment
- Further inpatient treatment
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NON_RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: home PAC
A home PAC team will care for patients in his/her home within 3 weeks after acute hospitalization.
The patient will get a physical therapy (PT) or occupational therapy (OT) 1 to 6 session(s) per week.
|
Strengthening exercise, range-of-motion exercise, functional training, balance training, adjustment for assistive devices, adaptation and modification of the home environment, and patient/caregiver education
|
ACTIVE_COMPARATOR: hospital PAC
A rehabilitation PAC team will care for patients in the hospital within 3 weeks after acute hospitalization.
The patient will have 1 to 2 session(s) of PT or OT on weekdays, and a daily physician visit and nurse care.
|
Strengthening exercise, range-of-motion exercise, functional training, balance training, adjustment for assistive devices, adaptation and modification of the home environment, and patient/caregiver education
|
NO_INTERVENTION: conventional care group
usual care
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
30-second sit to stand
Time Frame: within 1 year
|
Ask participants to cross their arms at the chest, and to perform sit to stand as more as possible within 30 seconds.
Measure the repetitions the participants do.
Higher repetition indicates more strength of lower extremities.
|
within 1 year
|
Activities of daily living Using the Barthel Index (BI)
Time Frame: within 1 year
|
Using the Barthel Index (BI) to measure participants' activities of daily living.
The self-care domain is self-report by the patient or their families.
The mobility domain is observed by the assessor.
The greater score indicates more independence.
|
within 1 year
|
Functional performance of hip Using the Harris hip score (HHS)
Time Frame: within 1 year
|
Using the Harris hip score (HHS) to measure participants' functional performance of hip.
The pain domain is self-report by the patient.
The function, deformity, and range of motion domain are observed by the assessor.
The greater score indicates the better functional performance of hip.
|
within 1 year
|
Pain intensity Using the numerical pain rating scale (NPRS)
Time Frame: within 1 year
|
Using the numerical pain rating scale (NPRS) to measure participants' pain intensity.
Ask participants to report their pain intensity with the 11-point scale (from 0 no pain to 10 worst possible pain).
|
within 1 year
|
Quality of lives Using the EuroQol instrument (EQ-5D)
Time Frame: within 1 year
|
Part 1: Ask participants to measure their mobility, self-care, usual activities, pain/discomfort, and anxiety/depression with the 3-point scale.
The greater score indicates poor quality of life.
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within 1 year
|
Quality of lives Using the EuroQol instrument (EQ-5D)
Time Frame: within 1 year
|
Part 2: Ask participants to measure their quality of life with a 20-cm visual analog scale.
The greater score indicates a better quality of life.
|
within 1 year
|
Caregiver strain Using the caregiver strain index (CSI)
Time Frame: within 1 year
|
Using the caregiver strain index (CSI) to measure the strain of caregiver.
Ask them to fill a 13-item questionnaire.
Greater value indicates a higher strain.
|
within 1 year
|
Medical Costs
Time Frame: within 1 year
|
Ask participants to record their direct medical cost and indirect medical cost within one year after hip fracture.
|
within 1 year
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Shih-Liang Shih, PhD., Department of Orthopaedic, Taipei City Hospital, Zhongxing Branch
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (ACTUAL)
March 2, 2020
Primary Completion (ACTUAL)
December 31, 2020
Study Completion (ACTUAL)
December 31, 2021
Study Registration Dates
First Submitted
February 25, 2020
First Submitted That Met QC Criteria
February 26, 2020
First Posted (ACTUAL)
February 27, 2020
Study Record Updates
Last Update Posted (ACTUAL)
July 5, 2022
Last Update Submitted That Met QC Criteria
June 30, 2022
Last Verified
June 1, 2022
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- PAC for hip fracture
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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