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Thursday, December 3, 2020

Research to improve care for hip surgery patients

Hip fractures pose a major risk of death for people over 50 years of age.

However, a new study is hoping to establish evidence for improved discharge planning for elderly patients after hip surgery.

Lead researcher, Laureate Professor Rob Sanson-Fisher, said recovery following a broken hip could be a long and incredibly difficult process.

“Of people aged over 50 with a hip fracture, one in three are at risk of dying within 12 months,” he said.

“In elderly patients, this risk is five to eight times higher within the first three months of fracture.

“In addition to pain, a hip fracture can dramatically impact quality of life, with reduced mobility, reduced independence, and reduced social engagement.

“Hip fractures can be the tipping point for elderly people to move into aged care facilities, and other conditions, such as dementia, can be exacerbated.”

According to Professor Sanson-Fisher, only 24% of hospitals routinely provide patients with written plans after surgery.

This is despite the Australian Hip Fracture Clinical Care Standard recommending all hip fracture patients receive an individualised written care plan.

Backed by funding of almost $500,000 from the National Health and Medical Research Council (NHMRC), Professor Sanson-Fisher will lead a multi-disciplinary team of researchers from the University of Newcastle, the Hunter Medical Research Institute and Hunter New England Health.

This study, relying on a highly-skilled team of clinicians, geriatricians, health behavioural scientists, biostatisticians and health economists, will investigate interventions to improve quality of life and reduce the likelihood of hospital re-admissions for hip fracture patients.

A randomised, controlled trial will test the health outcomes and cost-effectiveness of a multicomponent discharge package delivered to older people who have sustained a broken hip.

Patients and their nominated support persons will be randomised to either usual care or a novel action-oriented discharge procedure.

The new approach to be tested will incorporate a discharge planning session with an orthogeriatric advanced trainee and a written action plan tailored to individual needs.

A discharge letter will be sent to the patient’s general practitioner within 48 hours of discharge; and cues and reminders to promote adherence to the action plan will be provided.

Assessments of the health outcomes of the tailored approach to discharge procedure will be obtained via self-report surveys 90 days after discharge.

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