Occupational Therapy in HomEcare Re-ablement Services (OTHERS): study protocol for a randomized controlled trial.

Phillip J Whitehead,Avril Er Drummond,Zaid Latif,Ian D Mcgeorge,Ruth H Parry,Marion F Walker

doi:10.1186/1745-6215-15-447

Phillip J Whitehead, Avril Er Drummond + Show 4 more

Open Access

https://doi.org/10.1186/1745-6215-15-447

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Abstract

BackgroundHomecare re-ablement services have been developed by local authorities in England in response to the government agenda for health and social care. These services aim to optimize users’ independence and ability to cope at home, and reduce the need for ongoing health and social care services. However, there is currently limited evidence and guidance regarding the optimum configuration and delivery of re-ablement services. In particular, the impact of occupational therapy input on service user outcomes has been highlighted as a specific research priority.Methods/DesignThis feasibility randomized controlled trial (RCT) will recruit 50 people from one local authority led homecare re-ablement service in England. Those who provide informed consent will be randomized to receive either usual homecare re-ablement (without routine occupational therapy input) or usual homecare re-ablement plus an enhanced program targeted at activities of daily living (ADL), delivered by an occupational therapist. The primary aim of this study is to assess the feasibility of conducting a further, powered study. The participant outcomes assessed will be independence in personal and extended ADL, health and social care-related quality of life, number of care support hours, falls, acute and residential admissions and use of health and social care services. These will be assessed at two weeks, three months and six months post-discharge from the re-ablement service.DiscussionTo our knowledge, this is the first RCT of occupational therapy in homecare re-ablement services. The results of this study will lay the foundations for a further powered study. The findings will be relevant to researchers, clinicians, commissioners and users of adult social care services.Trial registrationCurrent Controlled Trials registration number: ISRCTN21710246 (registered on 31March 2014)

Highlights

Homecare re-ablement services have been developed by local authorities in England in response to the government agenda for health and social care
The findings will be relevant to researchers, clinicians, commissioners and users of adult social care services
This study reported that 29% of the users who received the reablement service had input from an occupational therapist during the re-ablement episode

Summary

Introduction

Homecare re-ablement services have been developed by local authorities in England in response to the government agenda for health and social care. In a homecare re-ablement service, users receive homecare but are supported to increase their ability to manage tasks independently, in order to reduce the amount of homecare they will require in the longer term [6] Such services have been developed by local authorities in England to work with people who are newly referred to social care services as needing homecare support [3,7]. This could mean adults having difficulties managing independently at home, for example, people leaving hospital, recovering from illness or injury or experiencing a new deterioration of a long-term condition. Comparable services are referred to as ‘restorative homecare’ [9,10,11,12], and may operate within similar parameters to homecare re-ablement

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