Rehabilitation in Primary Care: A Project to Maximize the Health Status of Adults With Chronic Illness

Not Applicable

Completed

Conditions: Chronic Disease
Hypertension
Back Pain
Obesity
Arthritis

Interventions: Behavioral: Occupational therapy
Behavioral: Physiotherapy
Behavioral: Self-management

Registration Number: NCT00229957

Lead Sponsor: Hamilton Health Sciences Corporation

Brief Summary: 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.

Detailed Description: 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.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 303

Inclusion Criteria

At least 1 chronic condition
3 visits to family physician in the past year

Exclusion Criteria

None

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intervention	Occupational therapy	Intervention
Intervention	Physiotherapy	Intervention
Intervention	Self-management	Intervention

Primary Outcome Measures

Name	Time	Method
SF-36 Physical Component	15 months	health related quality of life. Minimum: 0; Maximum 100.

Secondary Outcome Measures

Name	Time	Method
Use of Hospital Services	baseline, 15 months	self report use of hospital service
Independence in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs)	baseline, 15 months	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)
Functional Limitations	baseline, 15 months	Late Life Function and Disability Instrument: A measure of functional limitations and disability in older adults.
Falls and Injuries	baseline, 15 months	self-reported number of falls in last 6 months
HOME Falls and Accident Screening Tool (FAST)	baseline, 15 months	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.
Self-management and Self-efficacy	baseline, 15 months	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).
Physical Abilities (Strength, Balance)	baseline, 15 months	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).
Patient Satisfaction Questionnaire - 18 (Modified)	15 months	Patient satisfaction with the care they received. (Score range 0-5)