Enhanced interdisciplinary care improves self-care ability and decreases emergency department visits for older Taiwanese patients over 2 years after hip-fracture surgery: A randomised controlled trial
Abstract
Background Little evidence is available on the longer-term effects (beyond 12 months) of intervention models consisting of hip fracture-specific care in conjunction with management of malnutrition, depression, and falls. Objective To compare the relative effects of an interdisciplinary care, and a comprehensive care programme with those of usual care for elderly patients with a hip fracture on self-care ability, health care use, and mortality. Design Randomised experimental trial. Setting A 3000-bed medical centre in northern Taiwan. Participants Patients with hip fracture aged 60 years or older (N=299). Method Patients were randomly assigned to three groups: comprehensive care (n=99), interdisciplinary care (n=101), and usual care (control) (n=99). Usual care entailed only one or two in-hospital rehabilitation sessions. Interdisciplinary care included not only hospital rehabilitation, but also geriatric consultation, discharge planning, and 4-month in-home rehabilitation. Building upon interdisciplinary care, comprehensive care extended in-home rehabilitation to 12 months and added management of malnutrition and depressive symptoms, and fall prevention. Patients' self-care ability was measured by activities of daily living and instrumental activities of daily living using the Chinese Barthel Index and Chinese version Instrumental Activities of Daily Living scale, respectively. Outcomes were assessed before discharge, and 1, 3, 6, 12, 18, 24 months following hip fracture. Hie…
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A range of positive effects are reported after six to twelve months for nutritional interventions in orthogeriatric patients, e.g. reduced length of hospital stay, improved independence in activities of daily living, improved mobility, reduced in-hospital falls and fall-related injuries, decreased emergency department visits, significantly fewer days of delirium, fewer pressure ulcers, reduced-nut
“A range of positive effects are reported after six to twelve months, e.g.reduced length of hospital stay (55,56), improved independence in activities of daily living (56,192,193), improved mobility (56), reduced in-hospital falls and fall-related injuries (57), decreased emergency department visits (192) significantly fewer days of delirium (55), fewer pressure ulcers (55), reduced nursing home ad”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [192]
Cites
Malnutrition in hip fracture patients: an intervention study
Olofsson, B., Stenvall, M., Lundström, M., Svensson, O., & Gustafson, Y. (2007) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2006.01864.x · Cited by 138 · see citing works
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ESPEN practical guideline: Clinical nutrition and hydration in geriatrics
Volkert, D., Beck, A. M., Cederholm, T., Cruz-Jentoft, A., Hooper, L., Kiesswetter, E., Maggio, M., Raynaud-Simon, A., Sieber, C., Sobotka, L., et al. (2022) · Clinical Nutrition · doi:10.1016/j.clnu.2022.01.024 · Cited by 516 · see citing works
- Authors
- Shyu, Y.-I. L., Liang, J., Tseng, M.-Y., Li, H.-J., Wu, C.-C., Cheng, H.-S., Chou, S.-W., Chen, C.-Y., & Yang, C.-T.
- Affiliations
- Chang Gung University (TW)
- University of Michigan (US)
- Meiho University (TW)
- Chang Gung Memorial Hospital (TW)
- Corresponding author
- Shyu, Yea-Ing L.
- Venue
- International Journal of Nursing Studies
- Publisher
- Elsevier BV
- Published
- 2016-04
- Volume
- 56
- Pages
- 54-62
- ISSN
- 0020-7489 (ISSN-L)
- OpenAlex
- W2200761358
- Cited by
- 32
- References
- 1
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 1 · 2023: 4 · 2022: 8 · 2021: 3 · 2020: 3 · 2019: 3 · 2018: 2 · 2017: 1
- FWCI
- 1.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Nursing Studies (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Chang Gung Medical Foundation (94-422C)
- National Health Research Institutes (NHRI-EX98-9404PI)
- Chang Gung University (CMRPD1B0332, EMRPD1E1681)
- Topics
- Health Sciences › Medicine › Surgery › Hip and Femur Fractures
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Epidemiology › Bone fractures and treatments
- Keywords
- hip fracture, older adults, multidisciplinary care, comprehensive care, self-care ability, activities of daily living, instrumental activities of daily living, emergency department visits, hospital readmission, malnutrition, depression, fall prevention, home-based rehabilitation, geriatric consultation, discharge planning, long-term outcomes
- MeSH terms
- Aged, Comprehensive Health Care, Emergency Service, Hospital, Hip Fractures, Humans, Middle Aged, Self Care, Taiwan
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