Perceived Health Status and Capability after Hip Fracture: Secondary Outcomes from an Randomized Controlled Trial

Abstract

<b><i>Introduction:</i></b> Hip fractures can have a significant impact on the lives of older people and their families. We conducted a pragmatic randomized controlled trial of post-discharge comprehensive geriatric care (CGC) for community-dwelling older adults after a surgically repaired hip fracture. The objective of this study was to conduct a secondary analysis to compare changes in health status and perceived capability from baseline to 12 months after randomization with: the EuroQol 5-Dimension (EQ-5D-5L) (1) utility score and (2) visual analog scale (VAS); and (3) well-being as measured by participants’ perceptions of their ability (or capability) toward completing life activities using the ICEpop Capability Measure for Older People (ICECAP-O). <b><i>Methods:</i></b> We tested the effect of usual care (control) versus usual care and an outpatient CGC clinic (intervention) on mobility after hip fracture in community-dwelling older adults (65 years+). In this secondary analysis, we report the following outcomes: EQ-5D-5L utility score and VAS collected monthly via telephone and ICECAP-O collected in person three times at baseline, 6 months, and 12 months. Data were analyzed using area under the curve and regression adjusted for baseline values for utility scores and capability, and constrained longitudinal data analysis for VAS. <b><i>Results:</i></b> We enrolled 53 older adults, including 34 women and 19 men, with mean (SD) age of 80 (8) years. There were no statistical or clinically meaningful differences between groups (control group – intervention group values) for all variables: utility score = −0.028 (95% CI: −0.071, 0.014; <i>p</i> = 0.18); VAS: −0.03 (95% CI: −0.39 to 0.33; <i>p</i> = 0.86); and capability = −0.021 (95% CI: −0.090, 0.046; <i>p</i> = 0.54). <b><i>Conclusions:</i></b> There were no differences in outcomes between groups over 12 months, but values remained constant, contrary to a potential decline for this age group, especially after a major life event like a hip fracture.