The H2H study: Hospital-to-Home digital pathway post hip fracture
Research type
Research Study
Full title
The H2H Study: Hospital-to-Home digitally enabled exercise pathways to improve older adult’s post-operative outcomes during the COVID-19 pandemic
IRAS ID
284938
Contact name
Luke Hodgson
Contact email
Sponsor organisation
Western Sussex Hospitals NHS Foundation Trust
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
The current COVID-19 crisis has disproportionately affected older people in our society. Providing optimal healthcare whilst shielding and social distancing continue is a significant issue to be addressed. Surgical procedures provide extra challenges, being associated with reduced mobility and muscle mass and subsequent re-adjustment back to normal lives and routines. With a reduction in social support from families and friends, older people are at increased risk of physical and psychological stress and potential for longer hospital stays.
Within the current 'COVID-19 environment' we will seek to optimise older person’s rehabilitation, following a hip fracture, using wearable devices (a 'smartwatch') and bespoke physiotherapy regimes to improve the pathway between hospital and community care. Patients and the public have been involved throughout the project and will help disseminate findings.
Aims:
1. Perform a non-randomised prospective intervention study (intervention and control cohorts) to assess feasibility of an integrated, iterative pathway, using a smartwatch and online application (mHealth) to support patients and staff. Feasibility indicators (recruitment, intervention delivery, collecting outcomes, costs, power) will inform a definitive randomised controlled trial (RCT).2. Explore intervention acceptability during the COVID-19 environment through patient and staff qualitative interviews.
50 patients will be recruited from an intervention site. Main outcomes collected as usual care will be compared to those of 50 controls.
Outcomes: Acceptability and feasibility ascertained through patient reported experience measures and interviews. Objective outcomes: return home, mortality, pain, activities of daily living, mobility, health-related quality of life; hospital stay, re-admissions, falls and physical activity. Health Economic and Sustainability assessments will be conducted.
Necessary use of technology, triggered by COVID-19 will be used as an opportunity to integrate patient-centred rehabilitation. This work targets a key performance indicator for the National Hip Fracture Database: helping people get back home. If feasible this would offer continuity of care from hospital-to-home and inform a definitive RCT.
REC name
South East Scotland REC 01
REC reference
20/SS/0088
Date of REC Opinion
16 Sep 2020
REC opinion
Further Information Favourable Opinion