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

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ClinicalTrials.gov Identifier: NCT00229957
Recruitment Status : Completed
First Posted : September 30, 2005
Results First Posted : July 7, 2010
Last Update Posted : July 20, 2010
Sponsor:
Collaborator:
Ontario Ministry of Health and Long Term Care
Information provided by:
McMaster University

Study Description
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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.

Condition or disease Intervention/treatment Phase
Chronic Disease Hypertension Back Pain Obesity Arthritis Behavioral: Occupational therapy Behavioral: Physiotherapy Behavioral: Self-management Not Applicable

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.


Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 303 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Rehabilitation in Primary Care: A Project to Maximize the Health Status of Adults With Chronic Illness
Study Start Date : June 2004
Actual Primary Completion Date : August 2006
Actual Study Completion Date : October 2006

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
Experimental: Intervention
Intervention
 Behavioral: Occupational therapy
Behavioral: Physiotherapy
Behavioral: Self-management
No Intervention: Control
Control group received usual care in primary care.


Outcome Measures
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Primary Outcome Measures :
  1. SF-36 Physical Component [ Time Frame: 15 months ]
    health related quality of life. Minimum: 0; Maximum 100.


Secondary Outcome Measures :
  1. Use of Hospital Services [ Time Frame: baseline, 15 months ]
    self report use of hospital service

  2. Independence in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) [ Time Frame: 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)

  3. Functional Limitations [ Time Frame: baseline, 15 months ]
    Late Life Function and Disability Instrument: A measure of functional limitations and disability in older adults.

  4. Falls and Injuries [ Time Frame: baseline, 15 months ]
    self-reported number of falls in last 6 months

  5. HOME Falls and Accident Screening Tool (FAST) [ Time Frame: 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.

  6. Self-management and Self-efficacy [ Time Frame: 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).

  7. Physical Abilities (Strength, Balance) [ Time Frame: 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).

  8. Patient Satisfaction Questionnaire - 18 (Modified) [ Time Frame: 15 months ]
    Patient satisfaction with the care they received. (Score range 0-5)


Eligibility Criteria
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Ages Eligible for Study:   44 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

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

Exclusion Criteria:

Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00229957


Locations
Canada, Ontario
Stonechurch Family Health Centre, 549 Stonechurch Rd. E.
Hamilton, Ontario, Canada, L8W 3L2
Sponsors and Collaborators
Hamilton Health Sciences Corporation
Ontario Ministry of Health and Long Term Care
Investigators
Principal Investigator: Lori Letts, PhD McMaster University
Principal Investigator: Julie Richardson, PhD McMaster University
More Information
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Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

ClinicalTrials.gov Identifier: NCT00229957     History of Changes
Other Study ID Numbers: 04-052
G03-02572
First Posted: September 30, 2005    Key Record Dates
Results First Posted: July 7, 2010
Last Update Posted: July 20, 2010
Last Verified: September 2009

Keywords provided by McMaster University:
Occupational therapy
Physical therapy techniques
Primary health care
Chronic disease
 Rehabilitation
Disease management
Self care

Additional relevant MeSH terms:
Back Pain
Chronic Disease
Pain
Neurologic Manifestations
 Nervous System Diseases
Signs and Symptoms
Disease Attributes
Pathologic Processes