Back to the future

This blog post describes the pilot study "Back to the Future", which provides older adults recovering from hip fracture with the right information at the right time to help them remain independent at home and active in their community.

Kristin Brown is the research coordinator for the Hip Fracture Interview Study, which runs through the Activity & Aging Lab (A3) at the Centre for Hip Health & Mobility (CHHM) and Vancouver Coastal Health (VCH). Dolores Langford is Regional Clinical Resource Physiotherapist, Orthopaedic and Musculoskeletal Populations, VCH. Maureen Ashe is Associate Professor in the UBC Department of Family Practice, an investigator at the CHHM, an MSFHR Scholar and a CIHR New Investigator. Read about the A3 Lab.

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How does one person manage their own care after hip fracture? By utilizing lessons learned from many.

30,000 Canadians are admitted to hospital each year because of hip fractures [1].

Few things are more overwhelming than being hospitalized, and an important goal of hospital staff is to discharge patients to their own home as quickly as possible. But what happens when older adults finally get home and are suddenly alone? How do they transition from having many health professionals involved in their recovery, to being responsible for their own care?

To be successful in managing their recovery at home, we believe older adults need the right information, at the right time, coupled with more support. We hope that by providing these resources through our pilot study "Back to the Future" (B2F), older adults recovering from hip fracture will be better able to remain independent at home and active in their community.

We utilized an integrated knowledge translation approach to design our B2F intervention. We worked closely with health care professionals across a number of disciplines and health authorities to develop a hip fracture educational booklet that provides essential material to older adults and their caregivers in a manageable format – the right information.

We also created four videos, two of individuals who share their personal insight into the hip fracture recovery process, and two of health professionals who give practical advice for the early recovery stage. The booklet and videos are all centered around themes identified as important to the recovery process by older adults with hip fracture and their caregivers [2].

It is especially important that this guidance and knowledge is provided immediately after discharge – the right time – when the recovery process can be especially overwhelming due to pain, limited mobility, and responsibility for one’s care. Finally, we recognize that education alone is not sufficient, so our intervention reinforces the educational components with follow-up coaching telephone calls [3] – more support.

The design of our intervention has incorporated valuable input from older adults and health care professionals, from whom we will seek further feedback at the completion of the B2F pilot study. We will interview the participants and hospital staff directly involved in the study to assess the acceptability of our intervention and to inform a larger clinical trial. Additionally, we will continue to work with relevant stakeholders to develop our hip fracture booklet, as we envision wider distribution of this educational tool – so that the collaborative efforts of many can help each individual to be successful in their recovery.

For additional information, please see ClinicalTrials.gov (NCT01930409) or http://www.vchri.ca/feature-stories/articles/2013/09/06/bridging-gap-between-hospital-and-home-after-fracture


References

  1. Osteoporosis Canada. 2013. “Osteoporosis Facts & Figures”. Accessed 2013 November 14. http://www.osteoporosis.ca/osteoporosis-and-you/osteoporosis-facts-and-s....

  2. Schiller C, Franke T, Sims-Gould J, Hoppmann C, Sale J, Ashe MC. Navigating the journey after hip fracture; older adults’ perspectives to inform the development of a toolkit. Poster session presented at: 41st Annual Meeting of the North American Primary Care Research Group; 2013 November 9-13; Ottawa, Ontario.

  3. Coleman EA, Parry C, Chalmers S, Min SJ. The care transitions intervention: results of a randomized controlled trial. Arch Intern Med 2006; 166(17): 1822-8.

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