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Occupational Therapy in HomEcare Re-ablement Services (OTHERS): results of a feasibility randomised controlled trial

Whitehead, Phillip J.; Walker, Marion F.; Parry, Ruth H.; Latif, Zaid; McGeorge, Ian D.; Drummond, Avril E.R.

Authors

Phillip J. Whitehead

Marion F. Walker

Ruth H. Parry

Zaid Latif

Ian D. McGeorge

AVRIL DRUMMOND avril.drummond@nottingham.ac.uk
Professor of Healthcare Research



Abstract

Objectives: The objective of this study was to test the feasibility of conducting a randomised controlled trial (RCT) of an intervention targeted at activities of daily living (ADL), delivered by an occupational therapist, in homecare reablement.

Design: Feasibility parallel group RCT.

Setting: Single-site local authority homecare reablement service.

Participants: People referred for homecare reablement with ability to consent. Exclusion criteria were as follows: inability to speak English, receiving other community therapy services, needing two or more to assist transfer and receiving end-of-life care.

Control: ‘Usual care’ was 6 weeks of homecare reablement delivered by social care workers (no routine health professional input).

Intervention: A targeted ADL programme, delivered by an occupational therapist incorporating goal setting, teaching/practising techniques, equipment/adaptations and provision of advice/support. This was in addition to usual care.

Outcome measures: Aspects of feasibility including eligibility, recruitment, intervention delivery, attrition and suitability and sensitivity of outcome measures. Participant outcomes were personal and extended ADL, quality of life, falls and use of health and social care services.

Results: 30 participants were recruited, 15 to each arm, which was 60% of those eligible. Data from 22 (73%) were analysed at 6 months. Of the 15 participants, 13 (86%) received the intervention and were able to set one or more ADL goals. There were improvements from baseline in both groups, although overall improvements were greater in the occupational therapy (OT) intervention group. The biggest threat to feasibility was a change in service configuration during the trial, involving additional occupational therapy input, affecting usual care and recruitment.

Conclusions: Despite the service reconfiguration, it was feasible to recruit and retain participants, deliver the intervention and collect outcome data that were responsive to change. The choice of primary outcome measure remains unclear. A further powered study is feasible and warranted; however, the design will require careful consideration because of ongoing national changes in service configurations.

Citation

Whitehead, P. J., Walker, M. F., Parry, R. H., Latif, Z., McGeorge, I. D., & Drummond, A. E. (2016). Occupational Therapy in HomEcare Re-ablement Services (OTHERS): results of a feasibility randomised controlled trial. BMJ Open, 6(8), https://doi.org/10.1136/bmjopen-2016-011868

Journal Article Type Article
Acceptance Date Jul 18, 2016
Publication Date Aug 16, 2016
Deposit Date Oct 31, 2016
Publicly Available Date Oct 31, 2016
Journal BMJ Open
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 6
Issue 8
Article Number e011868
DOI https://doi.org/10.1136/bmjopen-2016-011868
Public URL http://eprints.nottingham.ac.uk/id/eprint/38066
Publisher URL http://dx.doi.org/10.1136/bmjopen-2016-011868
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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