The purpose of the study is to determine whether occupational therapy and physiotherapy delivered in a primary care setting to adults with chronic illness is effective in improving health.
Primary health care is changing so that people receive the care that they need at the front line. Rehabilitation has been identified as one service that should be offered in primary care, to address the needs of adults who have or are at risk of poor health from chronic conditions such as arthritis, heart disease and depression. Two full time therapists (one physiotherapist and one occupational therapist) will offer rehabilitation to a sample of 170 adults with chronic illness over an 18 month period (170 people will also be enrolled in a control group) at the Stonechurch Family Health Centre. Key outcomes include health, hospital admissions and emergency room visits.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
303
Stonechurch Family Health Centre, 549 Stonechurch Rd. E.
Hamilton, Ontario, Canada
SF-36 Physical Component
health related quality of life. Minimum: 0; Maximum 100.
Time frame: 15 months
Use of Hospital Services
self report use of hospital service
Time frame: baseline, 15 months
Independence in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs)
Late Life Function and Disability Instrument: A measure of disability and functional limitations in older adults. (Score range 0-100 with 100 representing better ability and less disability/functional limitation)
Time frame: baseline, 15 months
Functional Limitations
Late Life Function and Disability Instrument: A measure of functional limitations and disability in older adults.
Time frame: baseline, 15 months
Falls and Injuries
self-reported number of falls in last 6 months
Time frame: baseline, 15 months
HOME Falls and Accident Screening Tool (FAST)
This is a home assessment of safety hazards for falls present in the individual's home. This tool helps to identify seniors at risk of falls. Score 0-25.
Time frame: baseline, 15 months
Self-management and Self-efficacy
Individual's self-reported ability to carry out behaviours to self-manage their health condition, and their confidence level in being able to carry out these behaviours. (Score range 0= not confident at all, 10= totally confident).
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Time frame: baseline, 15 months
Physical Abilities (Strength, Balance)
Grip strength was measured using a JAMAR hand grip dynamometer (in kilograms). The Lower Extremity Function test is a battery of three tests used to measure lower extremity function and balance: a balance test, 8 foot walk test, and repetitive standing from a chair. A performance summary score is created by adding the number of seconds achieved on the balance test, the number of seconds to walk 8 feet and the number of seconds it takes the person to stand up from a chair five times consecutively (no maximum score exists on this measure).
Time frame: baseline, 15 months
Patient Satisfaction Questionnaire - 18 (Modified)
Patient satisfaction with the care they received. (Score range 0-5)
Time frame: 15 months