The main aim of this multi-centre stepped wedge randomized controlled trial is to improve the quality, professional practice and cost-effective utilization of health care resources by evaluating if a new rehabilitation program aimed at bridging gaps in rehabilitation across levels of care may increase and/or prolong the effect of rehabilitation.
The goal of rehabilitation is to help people to reach and maintain their optimal functioning and coping capabilities, and to promote independence and participation in society. According to current political documents, there are large variation in the content and quality of rehabilitation in Norway, and systems to improve coordination and communication are needed. This trial is a collaborative project between eight centres across Norway, investigating whether a new program aimed at bridging gaps in rehabilitation across levels of care increase and/or prolong the effect of rehabilitation for people with rheumatic and musculoskeletal diseases. Additionally, we will use a newly developed set of quality indicators to monitor and compare the quality of rehabilitation across different centres, and explore relationships between adherence to structure and process indicators and the outcomes of rehabilitation. The effects will be evaluated in a multi-centre stepped wedge randomized controlled trial, where participating centres switch from control (current rehabilitation program) to intervention phase (adding the BRIDGE program to the current program) in a randomized order. Primary outcome is goal attainment after seven months, and secondary outcomes are health related quality of life and function. The results will give insight in the content and organisation of current rehabilitation programs, what follow-up people want and receive in primary care, their planned and completed efforts to implement and maintain life style changes, and predictors for improvement following rehabilitation in specialist health care. Results will also have consequences on how rehabilitation is to be organized in the future regarding follow-up and coordination across levels of care. The study has been developed in close collaboration with patient research partners, clinicians and international experts, who will also contribute in the process of integrating study results in clinical practice.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
381
The control group will receive the rehabilitation currently offered at each of the participating centers.
The experimental group will additionally receive the BRIDGE program, which comprises motivational interviewing, structured goal-setting, tailored follow-up, plans for self-management, and individualised written feedback that participants can use to monitor their progress and share with important care givers.
Valnesfjord Rehabilitation Centre
Valnesfjord, Valnesfjord, Norway
Sørlandet Hospital
Arendal, Norway
Haugesund Rheumatism Hospital
Haugesund, Norway
Rehabilitering Vest
Haugesund, Norway
Goal attainment measured by the Patient Specific Functional Scale
Goal attainment will be measured by the Patient Specific Functional Scale
Time frame: One year
Health-related quality of life measured by the EQ5D
Health-related quality of life will be measured by the EQ5D
Time frame: One year
Physical function measured by the 30 sec sit to stand test
Physical function will be measured by the 30 sec sit to stand test
Time frame: One year
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Lillehammer Rheumatism Hospital
Lillehammer, Norway
Meråker rehabilitation centre
Meråker, Norway
Muritunet Rehabilitation Centre
Valldal, Norway
Vikersund Rehabilitation Centre
Vikersund, Norway