Abstract：
OBJECTIVE: Determine the feasibility of allied health assistant (AHA) management of people with hip fracture an acute hospital.
METHODS: Assessor-blind, parallel, feasibility randomised controlled trial with qualitative component.
METHODS: Acute orthopaedic ward.
METHODS: People with surgically-managed hip fracture, who walked independently pre-fracture and had no cognitive impairment.
METHODS: Rehabilitation from an AHA, under the supervision of a physiotherapist, compared with rehabilitation from a physiotherapist.
METHODS: Feasibility was evaluated according to focus areas of demand, acceptability, practicality and implementation. Secondary outcomes included estimates of effect of adherence to hip fracture mobilisation guidelines, discharge destination, 30-day readmission, functional activity, and length of stay.
RESULTS: Fifty people were allocated to receive rehabilitation from an AHA (n = 25) or physiotherapist (n = 25). AHA rehabilitation had high demand with 60% of eligible participants recruited. Satisfaction with AHA rehabilitation was comparable with physiotherapy rehabilitation (acceptability). The AHA group received an average of 11 min (95% CI 4 to 19) more therapy per day than the physiotherapy group (implementation). The AHA group may have had lower cost of acute care (MD -$3 808 95% CI -7 651 to 35) and adverse events were comparable between groups (practicality). The AHA group may have been 22% (HR 1.22, 95% CI 0.92 to 1.61) more likely to walk on any day and may have had a shorter length of stay (MD -0.8 days, 95% CI -2.3 to 0.7).
CONCLUSIONS: AHA management of patients with hip fracture was feasible and may improve adherence to mobilisation guidelines and reduce cost of care and length of stay.
BACKGROUND: ACTRN12620000877987. CONTRIBUTION OF THE PAPER.
METHODS: Assessor-blind, parallel, feasibility randomised controlled trial with qualitative component.
METHODS: Acute orthopaedic ward.
METHODS: People with surgically-managed hip fracture, who walked independently pre-fracture and had no cognitive impairment.
METHODS: Rehabilitation from an AHA, under the supervision of a physiotherapist, compared with rehabilitation from a physiotherapist.
METHODS: Feasibility was evaluated according to focus areas of demand, acceptability, practicality and implementation. Secondary outcomes included estimates of effect of adherence to hip fracture mobilisation guidelines, discharge destination, 30-day readmission, functional activity, and length of stay.
RESULTS: Fifty people were allocated to receive rehabilitation from an AHA (n = 25) or physiotherapist (n = 25). AHA rehabilitation had high demand with 60% of eligible participants recruited. Satisfaction with AHA rehabilitation was comparable with physiotherapy rehabilitation (acceptability). The AHA group received an average of 11 min (95% CI 4 to 19) more therapy per day than the physiotherapy group (implementation). The AHA group may have had lower cost of acute care (MD -$3 808 95% CI -7 651 to 35) and adverse events were comparable between groups (practicality). The AHA group may have been 22% (HR 1.22, 95% CI 0.92 to 1.61) more likely to walk on any day and may have had a shorter length of stay (MD -0.8 days, 95% CI -2.3 to 0.7).
CONCLUSIONS: AHA management of patients with hip fracture was feasible and may improve adherence to mobilisation guidelines and reduce cost of care and length of stay.
BACKGROUND: ACTRN12620000877987. CONTRIBUTION OF THE PAPER.
摘要：
目的：确定急性医院髋部骨折患者的专职医疗助理（AHA）管理的可行性。
方法：评估者盲，平行,具有定性成分的可行性随机对照试验。
方法：急性骨科病房。
方法：手术治疗髋部骨折患者，骨折前独立行走，没有认知障碍。
方法：来自AHA的康复，在物理治疗师的监督下,与物理治疗师的康复相比。
方法：根据需求的重点领域评估了可行性，可接受性,实用性和实施性。次要结果包括对遵守髋部骨折动员指南的效果的估计，排放目的地,重新接纳30天,功能活动，和逗留时间的长短。
结果：50人被分配接受AHA（n=25）或物理治疗师（n=25）的康复治疗。AHA康复的需求很高，招募了60％的合格参与者。对AHA康复的满意度与物理治疗康复相当（可接受性）。AHA组每天平均比物理治疗组多接受11分钟的治疗（95％CI4至19）（实施）。AHA组的急性护理费用可能较低（MD-$380895％CI-7651至35），两组之间的不良事件相当（实用性）。AHA组可能有22％（HR1.22，95％CI0.92至1.61）更有可能在任何一天行走，并且可能有较短的住院时间（MD-0.8天，95%CI-2.3至0.7）。
结论：AHA治疗髋部骨折患者是可行的，可以提高对动员指南的依从性，降低护理成本和住院时间。
背景：ACTRN12620000877987。论文的贡献。
方法：评估者盲，平行,具有定性成分的可行性随机对照试验。
方法：急性骨科病房。
方法：手术治疗髋部骨折患者，骨折前独立行走，没有认知障碍。
方法：来自AHA的康复，在物理治疗师的监督下,与物理治疗师的康复相比。
方法：根据需求的重点领域评估了可行性，可接受性,实用性和实施性。次要结果包括对遵守髋部骨折动员指南的效果的估计，排放目的地,重新接纳30天,功能活动，和逗留时间的长短。
结果：50人被分配接受AHA（n=25）或物理治疗师（n=25）的康复治疗。AHA康复的需求很高，招募了60％的合格参与者。对AHA康复的满意度与物理治疗康复相当（可接受性）。AHA组每天平均比物理治疗组多接受11分钟的治疗（95％CI4至19）（实施）。AHA组的急性护理费用可能较低（MD-$380895％CI-7651至35），两组之间的不良事件相当（实用性）。AHA组可能有22％（HR1.22，95％CI0.92至1.61）更有可能在任何一天行走，并且可能有较短的住院时间（MD-0.8天，95%CI-2.3至0.7）。
结论：AHA治疗髋部骨折患者是可行的，可以提高对动员指南的依从性，降低护理成本和住院时间。
背景：ACTRN12620000877987。论文的贡献。
