Providence Care, in collaboration with Queen’s University and Kingston Health Sciences Centre (KHSC), is facilitating research that hopes to change the way patients receive care in their homes post-hip fracture.
Senior Associate Researcher with Providence Care, Dr. Mohammad Auais is the project lead, working with a multi-disciplinary team of professionals from across Canada, including Providence Care physicians, Dr. Sudeep Gill and Dr. David Ruggles.
“We know from published research literature that more than half of hip fracture patients don’t recover, meaning they don’t ever go back to their pre-fracture, functional level,” explains Dr. Auais. “Although hip fracture surgeries are highly successful, the short-term and long-term outcomes for patients are discouraging. Many patients lose independence, need to enter long-term-care and a good percentage re-fracture either the same hip or the other hip. There’s a gap in care once the patient returns home after a hip fracture, and we believe we can improve that gap,” he adds.
The ‘Stronger At Home’ research study will examine 200 hip fracture patients 65 and older over the next four years in the Kingston area. Individuals will be assigned randomly into two groups, a control (usual care) group that receives the current home-care services available, and the intervention (treatment) group that will receive a specialized, hybrid model of care for an intensive 14-week program and then follow up, in-person, and phone assessments for up to 12 months after discharge. This study will be run in collaboration with Home Care and Community Support Services.
“We are going to compare our intervention against the usual care to see which one will be more effective and cost effective,” explains Dr. Auais. “Our clinical team consists of physiotherapists and physiotherapy assistants who will visit the patient in their home every other week for 14 weeks. We have designed a structured, personalized care plan that will be tailored to the patient’s needs and goals that can be modified as the patient progresses. This model involves the patient being an active partner in the program and they will have to do their homework and exercise five times a week for at least 30 minutes.”
This study also considers the barriers patients face during recovery, like pain. The intervention treatment will consist of a component that will also look at managing pain for the patient, with a focus on non-pharmacological interventions like exercise and education.
“Having the patient understand the pain mechanism and how the body responds to pain is important to recovery based on evidence,” explains Dr. Auais. “During this program, there will be an extra component of non-pharmacological pain management with the patient.”
‘Stronger at Home’ is receiving funding through the Canadian Institutes of Health Research and has been years in the making with pilot studies and pre-trials. Stakeholders, including caregivers, patients, healthcare professionals and hip fracture administrators were involved in designing this new intervention and model of care.
At Providence Care, physicians Dr. Gill and Dr. Ruggles will work together to assess a patient’s eligibility for the study recovering from hip fractures and receiving in-patient rehabilitation services at both Providence Care Hospital and Providence Transitional Care Centre.
“In an ideal world, patients receive therapy in a timely manner and in an appropriate dose after hospital discharge, but in the real world that’s not always the case,” says Dr. Gill. “Participants in this study will have access to high quality and timely care that is backed by a lot of evidence and research Dr. Auais has already done. This study is a wonderful opportunity for patients,” adds Dr. Gill.
Recruitment for the trial has begun and will continue on an ongoing basis for the next four years. The ‘Stronger at Home’ team hopes this research will aid in improving hip fracture outcomes, help aging adults avoid frailty, and live and age well at home.
“This project addresses a vital health system challenge: effectively helping older hip fracture patient’s access proper rehabilitation, so they can stay independent in their homes,” says Dr. Auais.
For more information on the Providence Care’s ongoing research visit: Research Department – Providence Care Hospital Kingston and for more details on the ‘Stronger at Home’ study email: email@example.com