ArticleBMJ open2017
Development of an evidence-based complex intervention for community rehabilitation of patients with hip fracture using realist review, survey and focus groups.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Hip fracture has profound psychosocial impacts: a systematic review of qualitative studies.Age and ageing · 2024Pooled it
- A community-based rehabilitation package following hip fracture: FEMuR III a multi-centre RCT, economic and process evaluation.Health technology assessment (Winchester, England) · 2025Trial
- Trial
- A cost-consequence analysis of a community-based rehabilitation programme following hip fracture (Fracture in the Elderly Multidisciplinary Rehabilitation-FEMuR III).Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Trial
- Mixed methods process evaluation of an enhanced community-based rehabilitation intervention for elderly patients with hip fracture.BMJ open · 2018Trial
- Evidence-based rehabilitation medicine: definition, foundation, practice and development.Medical review (2021) · 2024Review
- Physiotherapists' perspectives of barriers and facilitators to effective community provision after hip fracture: a qualitative study in England.Age and ageing · 2023Article
- What Works Where and How for Uptake and Impact of Artificial Intelligence in Pathology: Review of Theories for a Realist Evaluation.Journal of medical Internet research · 2023Review
- Article
- Article
- Article
- Systematic scoping review of frameworks used to develop rehabilitation interventions for older adults.BMJ open · 2019Article
- Hip fracture in the elderly multidisciplinary rehabilitation (FEMuR) feasibility study: testing the use of routinely collected data for future health economic evaluations.Pilot and feasibility studies · 2018Article
- A national survey of community rehabilitation service provision for people with long Covid in Scotland.F1000ResearchArticle
- Brain-In-Hand technology for adults with acquired brain injury: A convergence of mixed methods findings.Journal of rehabilitation and assistive technologies engineeringArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
Abstract
objectivesTo develop an evidence and theory-based complex intervention for improving outcomes in elderly patients following hip fracture.
designComplex-intervention development (Medical Research Council (MRC) framework phase I) using realist literature review, surveys and focus groups of patients and rehabilitation teams.
settingNorth Wales.
participantsSurveys of therapy managers (n=13), community and hospital-based physiotherapists (n=129) and occupational therapists (n=68) throughout the UK. Focus groups with patients (n=13), their carers (n=4) and members of the multidisciplinary rehabilitation teams in North Wales (n=13).
resultsThe realist review provided understanding of how rehabilitation interventions work in the real-world context and three programme theories were developed: improving patient engagement by tailoring the intervention to individual needs; reducing fear of falling and improving self-efficacy to exercise and perform activities of daily living; and coordination of rehabilitation delivery. The survey provided context about usual rehabilitation practice; focus groups provided data on the experience, acceptability and feasibility of rehabilitation interventions. An intervention to enhance usual rehabilitation was developed to target these theory areas comprising: a physical component consisting of six additional therapy sessions; and a psychological component consisting of a workbook to enhance self-efficacy and a patient-held goal-setting diary for self-monitoring.
conclusionsA realist approach may have advantages in the development of evidence-based interventions and can be used in conjunction with other established methods to contribute to the development of potentially more effective interventions. A rehabilitation intervention was developed which can be tested in a future randomised controlled trial (MRC framework phases II and III). TRIAL REGISTRATION NUMBER: ISRCTN22464643, Pre-results.
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