Abizanda 2011.
Methods | Design: Randomised controlled trial of a short‐term occupational therapy intervention in an acute geriatric unit Date of study: November 2002 to June 2003 Power calculation: Yes Frequency of outcomes assessment: Daily during hospitalisation Inclusion criteria: All patients aged 65 and over consecutively admitted to the acute geriatric unit with an acute medical illness or exacerbation of existing chronic condition Exclusion criteria: None reported |
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Participants | Number in study: 400 Country: Spain Setting: One acute geriatric unit Age: Mean age 83.7 years (SD 6.1) in intervention group, 83.3 years (SD 6.5) in control group Sex: 43.4% male in intervention group, 43.1% male in control group Co‐morbidity: Number of previous chronic conditions 3.8 in intervention group, 3.5 in control group Dementia: 35.3% in intervention group, 31.4% in control group |
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Interventions | Intervention: Occupational therapy intervention (OTI) schedule consisted of a daily 45‐minute session with patient and relative/caregiver Monday‐Friday for the duration of admission. Activities were carried out according to needs and day of admission. Therapeutic plan included: cognitive stimulation; instruction on preventing complications including immobility, confusion, falls, urinary incontinence, pressure sores; retraining in ADL; assessment of technical aids for home. Control: All participants received medical treatment, nursing care, physical therapy and social assistance. |
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Outcomes | 1. Incident delirium, measured using CAM 2. Length of admission 3. Activities of daily living (ADL), measured using Barthel index 4. In‐hospital mortality 5. Adverse events |
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Notes | Funding source: Institute of Health Sciences, Junta de Comunidades de Castilla‐La Mancha. Declarations of interest: "All authors declare that there is not any personal, financial or potential conflict of interest, and therefore have nothing to declare." Delirium excluded at enrolment |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Low risk | Assignment to randomised group by a geriatrician who did not participate in the clinical management of participants |
Random sequence generation (selection bias) | Low risk | Computerised randomisation system |
Blinding of participants and personnel (performance bias) All outcomes | High risk | The geriatricians caring for the patients and providing their routine care were blinded to allocated group. Participants were not blinded due to the nature of the intervention. |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Outcome assessor and the individual performing data analysis were blinded |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Number with missing data are balanced between groups and there do not appear to be any systematic differences between the groups. |
Selective reporting (reporting bias) | Low risk | No changes were made to trial outcomes after the trial was initiated |
Other bias | Low risk | No evidence of other bias |