Hospital-based caregiver intervention for people following hip fracture surgery (HIP HELPER): multicentre randomised controlled feasibility trial with embedded qualitative study in England

• Published in: BMJ open Vol. 13; no. 12; p. e073611
• Main Authors: Smith, Toby O, Khoury, Reema, Hanson, Sarah, Welsh, Allie, Grant, Kelly, Clark, Allan B, Ashford, Polly-Anna, Hopewell, Sally, Pfeiffer, K, Logan, Phillipa, Crotty, Maria, Costa, Matthew L, Lamb, Sarah, Clifford, Penny, Freeman, Lis, Gray, Rene, Cunningham, Yan, Langford, Sarah, Baxter, Dr Mark, Pawson, Jessica, Taylor, Melissa, Mellows, Anna, Lacey, Kate, Herring, Alex, Williams, Diane, Cromie, Anna, Menton, Gail, Corbett, Warren, Jowett, Helen, Joshi, Vishwanath, Matharu, Maninderpal, Baggot, Maria, Dutton, Susan, Sahota, Opinder, Sheehan, Katie
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 09-12-2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Caregivers; Cognitive ability; Consent; COVID-19; Data collection; Ethnicity; Feasibility; Fractures; Health services; hip; Hip joint; Hospitals; Medical personnel; nursing care; orthopaedic & trauma surgery; Orthopedics; Pandemics; Patients; Professionals; Qualitative research; Rehabilitation Medicine; Surgery; United Kingdom > UK; England; rehabilitation medicine; nursing care; orthopaedic & trauma surgery; hip
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-073611

ObjectivesTo assess the feasibility of conducting a pragmatic, multicentre randomised controlled trial (RCT) to test the clinical and cost-effectiveness of an informal caregiver training programme to support the recovery of people following hip fracture surgery.DesignTwo-arm, multicentre, pragmatic, open, feasibility RCT with embedded qualitative study.SettingNational Health Service (NHS) providers in five English hospitals.ParticipantsCommunity-dwelling adults, aged 60 years and over, who undergo hip fracture surgery and their informal caregivers.InterventionUsual care: usual NHS care. Experimental: usual NHS care plus a caregiver–patient dyad training programme (HIP HELPER). This programme comprised three, 1 hour, one-to-one training sessions for a patient and caregiver, delivered by a nurse, physiotherapist or occupational therapist in the hospital setting predischarge. After discharge, patients and caregivers were supported through three telephone coaching sessions.Randomisation and blindingCentral randomisation was computer generated (1:1), stratified by hospital and level of patient cognitive impairment. There was no blinding.Main outcome measuresData collected at baseline and 4 months post randomisation included: screening logs, intervention logs, fidelity checklists, acceptability data and clinical outcomes. Interviews were conducted with a subset of participants and health professionals.Results102 participants were enrolled (51 patients; 51 caregivers). Thirty-nine per cent (515/1311) of patients screened were eligible. Eleven per cent (56/515) of eligible patients consented to be randomised. Forty-eight per cent (12/25) of the intervention group reached compliance to their allocated intervention. There was no evidence of treatment contamination. Qualitative data demonstrated the trial and HIP HELPER programme was acceptable.ConclusionsThe HIP HELPER programme was acceptable to patient–caregiver dyads and health professionals. The COVID-19 pandemic impacting on site’s ability to deliver the research. Modifications are necessary to the design for a viable definitive RCT.Trial registration numberISRCTN13270387.