Patients in the driving seat to improve outcomes during rehabilitation

During rehabilitation we know patients don’t often receive enough therapy and actually spend most of the day sitting and lying down. Participating in more occupational therapy and physiotherapy during inpatient rehabiliation enables patients to achieve better function and quality of life, and return home sooner.

Increasing the amount of supervised therapy is not always an option however, as extra staffing costs places considerable pressure on hospital budgets and resources.

My Therapy was an original program conceived and piloted at Cabrini, that was led by Dr Natasha Brusco. It is a consumer driven, self-management program designed to increase the amount of therapy participation by patients, through independent practice of exercise and activity in addition to usual care, without the need for additional staff. It is tailored to individual needs, prescribed by a patient’s treating occupational therapist and physiotherapist, and is practiced within business hours, evenings or weekends. The pilot study demonstrated that patients participating in My Therapy can achieve 100 minutes of extra weekly practice alongside usual care inpatient rehabilitation. For every patient receiving usual care who achieved a minimal important difference in function from admission to discharge, two patients receiving My Therapy achieved the same improvement in function. The benefits were achieved without additional staff, adverse events or safety concerns.

The pilot study has now expanded to a NHMRC Partnership Grant led by Dr Brusco, with almost $1 million in funding across Alfred Health, Cabrini Health, Eastern Health, Healthscope, and Monash and La Trobe Universities. The NHMRC Partnership Grant will evaluate scaled up implementation of the My Therapy program, with respect to effectiveness, cost effectiveness and factors influencing implementation, across inpatient rehabilitation wards in the public and private partner healthcare organisations. The project will couple knowledge generation and knowledge translation with cost-effectiveness analyses.

Dr Brusco says My Therapy has the potential to influence national and international models of rehabilitation.

“By collaborating with clinicians and patient consumers, we can increase the dosage of rehabilitation. We expect this will help patients achieve a higher functional status by discharge, empower our patients and improve their ability to self-manage their health, as well as reduce the health service cost and rehabilitation length of stay.”

Whittaker SL, Taylor NF, Hill KD, Ekegren CL, Brusco NK. (2021) Self-managed occupational therapy and physiotherapy for adults receiving inpatient rehabilitation (‘My Therapy’): protocol for a mixed-methods process evaluation. BMC Health Serv Res. 21(1):810. doi: 10.1186/s12913-021-06463-8.

Brusco NK, Ekegren CL, Taylor NF, Hill KD, Lee AL, Somerville L, Lannin NA, Wade D, Abdelmotaleb R, Callaway L, Whittaker SL, Morris ME.Self-managed occupational therapy and physiotherapy for adults receiving inpatient rehabilitation (‘My Therapy’): protocol for a stepped-wedge cluster randomised trial. BMC Health Serv Res. 21(1):811. doi: 10.1186/s12913-021-06462-9.

CABRINI RESEARCH TEAM

Professor Gary Richardson OAM

Professor Mohammad Asghari-Jafarabadi

Dr Emma Baker

Leesa Horrigan

Donna Li

Ioana Logan

Bianca Noble

Anne Spence

CABRINI RESEARCH GOVERNANCE OFFICE

Deb Macdonald

Michele Tonkin

CABRINI RESEARCH HEALTH DATA MANAGEMENT

Justin Lang

Mr Gilbert Shardey

ACKNOWLEDGEMENT TO STAFF WHO HAVE LEFT (2021-22)

Jacky Fernandes

Sharon Guo

Luka Keighley

Karen Oliva

Associate Professor Wei Wang