Therapists’ perspectives on a new Structured Tailored approach to Rehabilitation AfTer hIp FragilitY fracture – the STRATIFY feasibility randomised controlled trial.

Title:

Therapists’ perspectives on a new Structured Tailored approach to Rehabilitation AfTer HIp FragilitY Fracture – the Stratify Feasibility Randomised Controlled Trial.

Background:

The stratify feasibility randomised controlled trial explored a risk-stratified rehabilitation intervention, where patients with hip fracture were categorised as low, medium, or high risk of poor outcome and received tailored interventions accordingly. This qualitative study aimed to understand therapists’ views on the acceptability of the approach, as well as barriers and facilitators to its implementation, to inform a future definitive trial.

Methods:

Following delivery of the intervention, all therapists took part in semi-structured interviews. The topic guide and deductive thematic analysis were informed by the Theoretical Framework of Acceptability, the Theoretical Domains Framework, and fidelity domains (delivery, receipt, and enactment).

Results:

Nine therapists (n = 5 physiotherapists, n = 4 occupational therapists) participated in interviews. All viewed the approach as acceptable and expressed positive attitudes towards the intervention. Key enablers included alignment with professional roles, permission to dedicate time to appropriate therapeutic activities of daily living, confidence in delivering the intervention, and optimism about its benefits. Reported barriers included limited time due to staffing and length of stay, challenges engaging participants in emotionally distressing circumstances, and the need for a consultee to support decision-making and goal-setting, particularly in the high-risk subgroup.

Conclusion:

The Stratify approach was acceptable to therapists. Key facilitators and barriers to implementation were identified to inform a future trial on the effectiveness of the approach.