Variations in the provision of occupational therapy for patients undergoing primary elective total hip replacement in the United Kingdom

Abstract

Despite growing interest in the potential of rehabilitation therapies to reduce patient dependency and maximise the benefits of surgical intervention, there is only limited information available on the nature of, and variation in, rehabilitation for common procedures such as total hip replacement. This paper describes the nature and variability of occupational therapy provision for patients undergoing primary elective total hip replacement in the United Kingdom, based on the results of a postal survey of National Health Service trusts providing orthopaedic surgery. A response rate of 69% (n=183) was obtained, yielding a final sample of 166 trusts. The widest variations in rehabilitation practice related to the provision of, and charges for, adaptive equipment; the presence of the therapist during preadmission clinics; the number of hours patients spent in contact with therapists during hospitalisation; and the provision of written information on the benefits of total hip replacement and the care of the hip beyond 3 months after surgery. These results suggest that considerable variation exists in the provision of occupational therapy for total hip replacement across the United Kingdom. Future research identifying the most effective configuration of therapeutic interventions is needed to inform the production of guidelines in this area.