The rehabilitation enhancing aging through connected health (REACH) study: study protocol for a quasi-experimental clinical trial
Abstract Background Mobility limitations among older adults increase the risk for disability and healthcare utilization. Rehabilitative care is identified as the most efficacious treatment for maintaining physical function. However, there is insufficient evidence identifying a healthcare model that...
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| Format: | Article |
| Language: | English |
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BMC
2017-09-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12877-017-0618-x |
| _version_ | 1818873663408046080 |
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| author | Meng Ni Lorna G. Brown Danielle Lawler Terry D. Ellis Tamara Deangelis Nancy K. Latham Jennifer Perloff Steve J. Atlas Sanja Percac-Lima Jonathan F. Bean |
| author_facet | Meng Ni Lorna G. Brown Danielle Lawler Terry D. Ellis Tamara Deangelis Nancy K. Latham Jennifer Perloff Steve J. Atlas Sanja Percac-Lima Jonathan F. Bean |
| author_sort | Meng Ni |
| collection | DOAJ |
| description | Abstract Background Mobility limitations among older adults increase the risk for disability and healthcare utilization. Rehabilitative care is identified as the most efficacious treatment for maintaining physical function. However, there is insufficient evidence identifying a healthcare model that targets prevention of mobility decline among older adults. The objective of this study is to evaluate the preliminary effectiveness of a physical therapy program, augmented with mobile tele-health technology, on mobility function and healthcare utilization among older adults. Methods This is a quasi-experimental 12-month clinical trial conducted within a metropolitan-based healthcare system in the northeastern United States. It is in parallel with an existing longitudinal cohort study evaluating mobility decline among community-dwelling older adult primary care patients over one year. Seventy-five older adults (≥ 65–95 years) are being recruited using identical inclusion/exclusion criteria to the cohort study. Three aims will be evaluated: the effect of our program on 1) physical function, 2) healthcare utilization, and 3) healthcare costs. Changes in patient-reported function over 1 year in those receiving the intervention (aim 1) will be compared to propensity score matched controls (N = 150) from the cohort study. For aims 2 and 3, propensity scores, derived from logistic regression model that includes demographic and diagnostic information available through claims and enrollment information, will be used to match treatment and control patients in a ratio of 1:2 or 1:3 from a Medicare Claims Registry derived from the same geographic region. The intervention consists of a one-year physical therapy program that is divided between a combination of outpatient and home visits (6–10 total visits) and is augmented on a computerized tablet using of a commercially available application to deliver a progressive home-based exercise program emphasizing lower-extremity function and a walking program. Discussion Incorporating mobile health into current healthcare models of rehabilitative care has the potential to decrease hospital visits and provide a longer duration of care. If the hypotheses are supported and demonstrate improved mobility and reduced healthcare utilization, this innovative care model would be applicable for optimizing the maintenance of functional independence among community-dwelling older adults. Trial registration ClinicalTrial.gov Identifier: NCT02580409 (Date of registration October 14, 2015). |
| first_indexed | 2024-12-19T12:58:17Z |
| format | Article |
| id | doaj.art-7e1024460f1543f3abd4d2bf10db1954 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-19T12:58:17Z |
| publishDate | 2017-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-7e1024460f1543f3abd4d2bf10db19542022-12-21T20:20:20ZengBMCBMC Geriatrics1471-23182017-09-0117111110.1186/s12877-017-0618-xThe rehabilitation enhancing aging through connected health (REACH) study: study protocol for a quasi-experimental clinical trialMeng Ni0Lorna G. Brown1Danielle Lawler2Terry D. Ellis3Tamara Deangelis4Nancy K. Latham5Jennifer Perloff6Steve J. Atlas7Sanja Percac-Lima8Jonathan F. Bean9Spaulding Rehabilitation HospitalSpaulding Rehabilitation HospitalSpaulding Rehabilitation HospitalCollege of Health and Rehabilitation Sciences, Boston UniversityCollege of Health and Rehabilitation Sciences, Boston UniversityHealth and Disability Research Institute, Boston University School of Public HealthHeller School for Social Policy and Management, Brandeis UniversityDivision of General Internal Medicine, Massachusetts General HospitalDivision of General Internal Medicine, Massachusetts General HospitalSpaulding Rehabilitation HospitalAbstract Background Mobility limitations among older adults increase the risk for disability and healthcare utilization. Rehabilitative care is identified as the most efficacious treatment for maintaining physical function. However, there is insufficient evidence identifying a healthcare model that targets prevention of mobility decline among older adults. The objective of this study is to evaluate the preliminary effectiveness of a physical therapy program, augmented with mobile tele-health technology, on mobility function and healthcare utilization among older adults. Methods This is a quasi-experimental 12-month clinical trial conducted within a metropolitan-based healthcare system in the northeastern United States. It is in parallel with an existing longitudinal cohort study evaluating mobility decline among community-dwelling older adult primary care patients over one year. Seventy-five older adults (≥ 65–95 years) are being recruited using identical inclusion/exclusion criteria to the cohort study. Three aims will be evaluated: the effect of our program on 1) physical function, 2) healthcare utilization, and 3) healthcare costs. Changes in patient-reported function over 1 year in those receiving the intervention (aim 1) will be compared to propensity score matched controls (N = 150) from the cohort study. For aims 2 and 3, propensity scores, derived from logistic regression model that includes demographic and diagnostic information available through claims and enrollment information, will be used to match treatment and control patients in a ratio of 1:2 or 1:3 from a Medicare Claims Registry derived from the same geographic region. The intervention consists of a one-year physical therapy program that is divided between a combination of outpatient and home visits (6–10 total visits) and is augmented on a computerized tablet using of a commercially available application to deliver a progressive home-based exercise program emphasizing lower-extremity function and a walking program. Discussion Incorporating mobile health into current healthcare models of rehabilitative care has the potential to decrease hospital visits and provide a longer duration of care. If the hypotheses are supported and demonstrate improved mobility and reduced healthcare utilization, this innovative care model would be applicable for optimizing the maintenance of functional independence among community-dwelling older adults. Trial registration ClinicalTrial.gov Identifier: NCT02580409 (Date of registration October 14, 2015).http://link.springer.com/article/10.1186/s12877-017-0618-xPhysical therapyMobilityGeriatricsHealthcare model |
| spellingShingle | Meng Ni Lorna G. Brown Danielle Lawler Terry D. Ellis Tamara Deangelis Nancy K. Latham Jennifer Perloff Steve J. Atlas Sanja Percac-Lima Jonathan F. Bean The rehabilitation enhancing aging through connected health (REACH) study: study protocol for a quasi-experimental clinical trial BMC Geriatrics Physical therapy Mobility Geriatrics Healthcare model |
| title | The rehabilitation enhancing aging through connected health (REACH) study: study protocol for a quasi-experimental clinical trial |
| title_full | The rehabilitation enhancing aging through connected health (REACH) study: study protocol for a quasi-experimental clinical trial |
| title_fullStr | The rehabilitation enhancing aging through connected health (REACH) study: study protocol for a quasi-experimental clinical trial |
| title_full_unstemmed | The rehabilitation enhancing aging through connected health (REACH) study: study protocol for a quasi-experimental clinical trial |
| title_short | The rehabilitation enhancing aging through connected health (REACH) study: study protocol for a quasi-experimental clinical trial |
| title_sort | rehabilitation enhancing aging through connected health reach study study protocol for a quasi experimental clinical trial |
| topic | Physical therapy Mobility Geriatrics Healthcare model |
| url | http://link.springer.com/article/10.1186/s12877-017-0618-x |
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