Assessment of rehabilitation potential in frail older people
| ISRCTN | ISRCTN31938453 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN31938453 |
| IRAS number | 227288 |
| Secondary identifying numbers | IRAS 227288, CPMS 36257 |
- Submission date
- 04/08/2021
- Registration date
- 05/10/2021
- Last edited
- 10/10/2022
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English summary of protocol
Background and study aims
The primary goal of rehabilitation is to enable individuals to maximise their participation in society through their daily activities. Clinicians increasingly recognise that this can be achieved with even the most physically and cognitively impaired adults. Therapists are often required to make decisions about a patient's potential to respond to rehabilitation interventions. Decisions about 'rehabilitation potential' can determine what rehabilitation services if any, older patients with complex health and social care needs are able to access as part of NHS care. In the hospital setting therapists may have limited time to assess and work with patients, families, and carers and the complexities of ageing may not always be fully appreciated. Structured approaches for assessing rehabilitation potential are needed.
The aim of this study is to evaluate whether it is feasible to deliver the Rehabilitation Potential Assessment Tool (RePAT) in the acute hospital setting and whether it is acceptable to healthcare professionals, older people living with frailty, and their carers.
Who can participate?
Physiotherapists and occupational therapists (staff participants) working on geriatric wards in the acute hospital setting.
Patient participants aged 65 years and older who are receiving rehabilitation assessments from staff participants and are willing to participate in the study. Family members of staff participants will be invited to take part in interviews to explore their views of the RePAT intervention.
What does the study involve?
Staff participants will attend a 60 minute RePAT intervention training session. They will be asked to fill in a demographic information sheet detailing their profession, job banding, and clinical experience in geriatrics. Staff participants and members of the study team will identify potential patient participants and assess them for capacity and suitability. Patient participants will receive usual care and then will be reassessed using RePAT by the staff participant. Patient characteristics that may inform predictions of rehabilitation potential will be recorded from medical notes and electronic records on a case report form.
All staff and patient participants will take part in a semi-structured interview to explore their experiences and views of RePAT. A sample of family participants will also be invited to take part in an interview.
What are the possible benefits and risks of participating?
Participants taking part in this study will receive no immediate therapeutic benefit. Participation in this study may influence how rehabilitation services are designed and provided for older people living with frailty. The RePAT intervention includes items frequently used in rehabilitation assessments but in a structured fashion.
Where is the study run from?
Nottingham University Hospitals NHS Trust and the University of Nottingham (UK)
When is the study starting and how long is it expected to run for?
November 2017 to November 2019
Who is funding the study?
National Institute for Health Research (UK)
Who is the main contact?
Dr Alison Cowley, alison.cowley@nottingham.ac.uk
Contact information
Scientific
Research & Innovation
Nottingham University Hospitals NHS Trust
QMC Campus
Derby Road
Nottingham
NG7 2UH
United Kingdom
 ORCID ID |
0000-0001-6858-475X |
|---|---|
| Phone | +44 (0)115 9691169 extension 77148 |
| alison.cowley@nuh.nhs.uk |
Study information
| Study design | Non-randomized single centre feasibility study |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Non randomised study |
| Study setting(s) | Hospital |
| Study type | Other |
| Participant information sheet | Not available in web format, please use contact details to request a participant information sheet. |
| Scientific title | A non-randomised feasibility study of the Rehabilitation Potential Assessment Tool (RePAT) in frail older people in the acute healthcare setting . |
| Study acronym | RePAT |
| Study objectives | To evaluate whether the RePAT intervention was feasible in the acute hospital setting and whether it was acceptable to healthcare professionals, older people living with frailty and their carers. |
| Ethics approval(s) | Approved 03/01/2018, The Yorkshire & The Humber – Bradford Leeds Research Ethics Committee (Jarrow Business Centre, Rolling Mill Road, Jarrow NE32 3DT, UK: +44(0)297 1048081; bradfordleeds.rec@hra.nhs.uk), ref: 17/YH/0356 |
| Health condition(s) or problem(s) studied | Older people living with frailty (multi-morbidity) |
| Intervention | RePAT comprises 15 items/questions relating to components of rehabilitation potential where clinicians document their assessment findings and clinical reasoning behind rehabilitation assessments. Staff participants attend a 60 minute training session on RePAT which includes: background to the development of RePAT, patient participant recruitment process, mental capacity, data collection and RePAT completion. A member of the study team will meet with staff participants after they complete their first RePAT intervention to provide support and mentorship and clarify questions on intervention completion. Staff participants assess patient participants as per usual clinical care and then re-assess using RePAT. |
| Intervention type | Other |
| Primary outcome measure | 1. Feasibility is tested by recruiting physiotherapy and occupational therapy participants delivering the RePAT intervention to patients alongside usual clinical care and uses the following criteria 1.1. Five staff members recruited within one month 1.2. Twenty five patient participants recruited within two months 1.3. Intervention delivered to 25 participants 1.4. Fidelity of item completion achieved on RePAT intervention at 80% 2. Acceptability is tested by conducting semi-structured interviews with staff, patient and carer participants. For staff participants interviews were completed within two weeks of completing all RePAT assessments. For patients and carers, interviews were completed within two days of receiving the RePAT intervention. Interview data were analysed using thematic analysis. |
| Secondary outcome measures | There are no secondary outcome measures |
| Overall study start date | 01/11/2017 |
| Completion date | 01/11/2019 |
Eligibility
| Participant type(s) | Mixed |
|---|---|
| Age group | Adult |
| Sex | Both |
| Target number of participants | Five staff participants and 25 patient participants. |
| Total final enrolment | 32 |
| Key inclusion criteria | Staff participants 1. Physiotherapists or occupational therapists working in the acute care setting with older people living with frailty, specifically carrying out rehabilitation assessments or programmes of rehabilitation. Patient participants 1. Participants identified as frail by staff delivering routine clinical care and those in receipt of rehabilitation assessments or programmes of rehabilitation. 2. Participants able to give informed consent or if assessed and deemed to lack capacity consultee agreement from carer or family member or appropriate consultee. Family/carer participants 1. Carers or family members of patient participants in receipt of rehabilitation assessments or rehabilitation programmes. |
| Key exclusion criteria | Staff participants 1. Participants involved in research studies exploring or testing rehabilitation potential, rehabilitation assessments or rehabilitation models of care for older people living with frailty. 2. Staff participants working in specialist stroke, end of life or fracture services. Patient Participants 1. Participants in receipt of specialist stroke rehabilitation, specialist fracture care, specialist end of life or with a terminal diagnosis. 2. Participants with advanced care plans or directives, which stated that they did not wish to take part in research studies. 3. Patient participants found to lack capacity for whom an appropriate consultee could not be identified. |
| Date of first enrolment | 01/03/2019 |
| Date of final enrolment | 01/06/2019 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centre
Derby Road
Nottingham
NG7 2UH
United Kingdom
Sponsor information
Hospital/treatment centre
QMC Campus
Derby Road
Nottingham
NG7 2UH
England
United Kingdom
| Phone | +44 (0)115 9249924 |
|---|---|
| R&I@nuh.nhs.uk | |
| Website | http://www.nuh.nhs.uk/ |
"ROR" |
https://ror.org/05y3qh794 |
Funders
Funder type
Government
Government organisation / National government
- Alternative name(s)
- National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
- Location
- United Kingdom
Results and Publications
| Intention to publish date | 10/09/2021 |
|---|---|
| Individual participant data (IPD) Intention to share | No |
| IPD sharing plan summary | Stored in repository |
| Publication and dissemination plan | Research findings will be disseminated via publication in an open-access academic journal, a report for the funder, and conference presentations. Findings will also form part of a thesis submitted to the University of Nottingham for the degree of Doctor of Philosophy. A video, for sharing on social media, will also be produced explaining the study background and findings. |
| IPD sharing plan | The datasets generated during and/or analysed during the current study will be stored in a non-publically available repository. All study documents and data will be held by the Chief Investigator on behalf of the sponsor and will be archived in secure facilities at the University of Nottingham. This will include all anonymised audio recordings study databases and associated meta-data encryption codes. Data will be stored for seven years. Access will be restricted to members of the study team and to people authorised by the Research Sponsors. By signing the consent form participants agree to this access for the current study and any further research that may be conducted in relation to it. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Thesis results | 24/11/2020 | 23/08/2021 | No | No | |
| Results article | 07/10/2022 | 10/10/2022 | Yes | No | |
| HRA research summary | 28/06/2023 | No | No |
Editorial Notes
10/10/2022: Publication reference added.
01/11/2021: The CPMS number was added.
23/08/2021: Trial's existence confirmed by The Yorkshire & The Humber – Bradford Leeds Research Ethics Committee.
