Occupational Therapy in Complex Patients: A Pilot Randomized Controlled Trial

• Main Authors: Martina Pellegrini, Debora Formisano, Veronica Bucciarelli, Margherita Schiavi, Stefania Fugazzaro, Stefania Costi
• Format: Article
• Language: English
• Published: Hindawi-Wiley 2018-01-01
• Series: Occupational Therapy International
• Online Access: http://dx.doi.org/10.1155/2018/3081094
• ISSN: 0966-7903; 1557-0703

Introduction. To determine effect size and feasibility of experimental occupational therapy (OT) intervention in addition to standard care in a population of complex patients undergoing rehabilitation in a hospital-home-based setting. Method. 40 complex patients admitted to the rehabilitation ward of the Local Health Authority-Research Institute of Reggio Emilia (Italy) were randomized in a parallel-group, open-label controlled trial. Experimental OT targeting occupational needs in the areas of self-care, productivity, and leisure was delivered by occupational therapists. Standard care consisted of task-oriented rehabilitation delivered by a multiprofessional team. Results. The experimental OT intervention was completed by 75% of patients assigned to this group. The average changes in the Canadian Occupational Performance Measure (COPM) performance score significantly and clinically favored experimental OT [−3,06 (−4.50; −1.61); delta>2 points, resp.]. Similar trends were detected for COPM satisfaction and independence in instrumental activities of daily living (ADL). At follow-up, level of social participation was higher for patients treated with experimental OT (p=0.043) than for controls. Conclusions. Experimental OT was feasible in complex patients in a hospital-home-based setting. It ameliorated both patients’ performance and satisfaction in carrying out relevant activities and improved independence in instrumental ADL. The trial is registered with ClinicalTrials.gov NCT02677766.