A physiotherapy-led transition to home intervention for older adults following Emergency Department discharge: a pilot feasibility randomised controlled trial

Part of Special Series: WONCA World Rural Health Conference Abstracts 2022go to url


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Mairéad Conneely1
BSc (Physiotherapy), Masters in Sports Physiotherapy , Lecturer *

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Aoife Leahy2

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Margaret O’Connor3
Consultant Geriatrician

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Ahmed Gabr4
SpR Geriatric Medicine

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Blessing Okpaje5
SpR in Geriatric Medicine

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Anastasia Saleh6
SpR in Geriatric Medicine

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Gillian Corey7
Specialist Research Nurse

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Louise Barry8
Specialist Research Nurse

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Anne Griffin9

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Íde O’Shaughnessy10
PhD student, Senior Occupational Therapist

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Lorna Ryan11

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Ida O’Carroll12
Nurse in Integrated Care

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Siobhán Leahy13
Lecturer, Physiotherapist

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Dominic Trépel14
Associate Professor

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Damien Ryan15

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Katie Robinson16
Senior Lecturer in Occupational Therapy

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Rose Galvin17
Senior Lecturer in Physiotherapy


* Mairéad Conneely


1, 9, 10, 16, 17 University of Limerick, Galway, Ireland

2, 3, 4, 5, 6, 7, 11, 12 Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland

8 School of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland

13 Department of Sport, Exercise & Nutrition, School of Science & Computing, Galway-Mayo Institute of Technology, Galway, Ireland

14 Trinity Institute of Neurosciences, School of Medicine, Trinity College Dublin, Dublin , Ireland

15 Limerick EM Education Research Training (ALERT), Emergency Department, University Hospital Limerick, Dooradoyle, Limerick, Ireland., Limerick, Ireland, Ireland


10 January 2023 Volume 23 Issue 1


RECEIVED: 20 September 2022

ACCEPTED: 20 September 2022


Conneely M, Leahy A, O’Connor M, Gabr A, Okpaje B, Saleh A, Corey G, Barry L, Griffin A, O’Shaughnessy Í, Ryan L, O’Carroll I, Leahy S, Trépel D, Ryan D, Robinson K, Galvin R.  A physiotherapy-led transition to home intervention for older adults following Emergency Department discharge: a pilot feasibility randomised controlled trial . Rural and Remote Health 2023; 23: 8154. https://doi.org/10.22605/RRH8154


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Introduction: Older adults frequently attend the emergency department (ED) and experience high rates of adverse outcomes following ED presentation including functional decline, ED re-presentation and unplanned hospital admission. Our aim was to evaluate the feasibility of a physiotherapy-led integrated care intervention for older adults discharged from the ED (ED-PLUS).

Methods: Older adults presenting to the ED with undifferentiated medical complaints and discharged within 72 hours were computer randomised in a ratio of 1:1:1 to deliver usual care, Comprehensive Geriatric Assessment (CGA) in the ED, or ED-PLUS (trial registration: NCT04983602). ED-PLUS is an evidence-based and stakeholder-informed intervention to bridge the care transition between the ED and community by initiating a CGA in the ED and implementing a 6-week, multi-component, self-management programme in the patient’s own home. Feasibility (recruitment and retention rates) and acceptability of the programme were assessed quantitatively and qualitatively. Functional decline was examined post-intervention using the Barthel Index. All outcomes were assessed by a research nurse blinded to group allocation.

Results: Twenty-nine participants were recruited, indicating 97% of our recruitment target; 90% of participants completed the ED-PLUS intervention. All participants expressed positive feedback about the intervention. The incidence of functional decline at 6 weeks was 10% in the ED-PLUS group versus 70%–89% in the usual care and CGA-only groups.

Discussion: High adherence and retention rates were observed among participants and preliminary findings indicate a lower incidence of functional decline in the ED-PLUS group. Recruitment challenges existed in the context of COVID-19. Data collection is ongoing for 6-month outcomes.

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