OPAL: Occupational advice for Patients undergoing Arthroplasty of the Lower limb

Project duration

27 months

Funder

National Institute for Health Research – Health Technology Assessment funding stream

Project staff

Paul Baker (CI)¹
Carol Coole ²
Avril Drummond ²
Catherine Hewitt³
Lucksy Kottam ¹
Catriona McDaid ³
Iain McNamara ⁴
Melanie Narayanasamy ²
Fiona Nouri ²
Amar Rangan ¹
Gerry Richardson ³
Sarah Ronaldson ³
Khosrow Sehat ⁵

Staff institutions

South Tees Hospitals NHS Foundation Trust¹
The University of Nottingham²
The University of York³
Norfolk and Norwich University Hospitals NHS Foundation Trust⁴
Nottingham Circle Partnership⁵

Key objectives

To evaluate the specific needs of the population of patients who are in work and intend to return to work following hip and knee replacement.
To establish how individual patients return to work.
To establish what evidence is currently available relating to return to work/occupational advice interventions following elective surgical procedures.
To understand the barriers preventing return to work that need to be addressed by an occupational advice intervention.
To develop and manualise a multidisciplinary occupational advice intervention tailored to the needs of this patient group.
To define a suitable measure of “return to work” through a systematic review and evaluation of specific measures.
To test the acceptability, practicality, and feasibility and potential cost of delivering the manualised intervention within current care frameworks and as a potential trial intervention.

Methods

Phase 1 has involved both a rapid evidence synthesis, and prospective cohort study to map current practice and barriers to change, regarding return to work. The cohort study recruited patients on the waiting list for hip or knee replacement surgery who were currently working, across the 3 sites. Information about pre-surgical activity, work roles, absenteeism and work place disability was collected at baseline (peri-operatively) and at 8, 16 and 24 weeks post operatively using questionnaires.

At each centre, individual qualitative interviews were undertaken in a sub group of patients and also surgeons, allied health professionals (AHPs) and nurses, general practitioners (GPs) and employers. These interviews have provided detailed information about the difficulties in current care and support available and have identified possible solutions to overcome them. Findings are currently being analysed and papers are in preparation.

Stage of development

The team are now in the process of generating a list of potential intervention components, informed by the findings of Phase 1.

In Phase 2 a modified Delphi technique will be used with the aim of reaching consensus on these components with the main stakeholder groups. The manualised intervention with then be feasibility tested with a sample of patients at each site.

Further information

Please contact Avril Drummond, at avril.drummond@nottingham.ac.uk or visit the OPAL website for further information.

Return to Rehabilitation