Project Name
Fracture in the Elderly Multidisciplinary Rehabilitation (FEMuR)

Value
£519,537

Funder
NIHR HTA

Principal Investigator
Dr Nefyn Williams, NWORTH, PCPH Bangor

Co-investigators
Wilkinson C, Lemmey AB, Rycroft-Malone J, Sackley C, Woods RT, Morrison VL, Whitaker CJ, Edwards RT, Andrew G, Okoro T, Logan PA, Alexander S

Type of study
Sys Review, Feasibility CT

Summary
Hip fracture is a common, major health problem in old age. It is strongly associated with other health problems, under-nutrition, frailty, and poor physical and mental functioning. Mortality is high with 25% dying within the following 12 months. Many who were living independently before their fracture lose their independence afterwards, so it imposes a large cost burden on society amounting to about £2 billion a year. As the population ages the numbers of elderly people falling and fracturing their hips is increasing. The National Institute of Health and Clinical Excellence has issued draft guidelines for the management of hip fracture. As well as prompt surgical treatment the guidelines recommend that the associated medical needs are assessed promptly by a physician specialised in caring for this patient group, who can also identify goals for a programme of multidisciplinary rehabilitation. Such rehabilitation starts whilst in hospital during post-operative recovery and continues in the community following hospital discharge. Systematic reviews of multidisciplinary rehabilitation have concluded that they may aid recovery after a hip fracture, but the results were not conclusive and more research is needed. Current rehabilitation programmes are run separately in hospitals and in the community. Local health boards in Wales incorporate both primary and secondary care and present an opportunity to design a new programme, which can operate across the interface between these sectors, using a case management approach.

Study sponsor
Cardiff University

School role
WSPCR led

Link with RDG / CSG
NWORTH – North Wales Primary Care & Public Health Dpt - Led

Start date
November 2012

End date
September 2016