Poster Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2026

HITH4HIPs: A feasibility trial of hospital in the home after hip fracture (#289)

Danielle Ní Chróinín 1 , Thuỳ Anh Bùi 2 , Bernadette Brady 2 3 4 , Seema P Radhakrishnan 5 6 , Lynette McEvoy 3 , Serena Hong 3 7 , David Lim 8 9 , Joseph Descallar 2 10 , Jonathan Penm 11 12 , Lara Kimmel 13 14 , Marie March 15 , Ian A Harris 1 16 , Nathan Johns 13 17 , Jessica Angus 3 , Elise Tcharkhedian 3 , Tai Tak Wan 5 , Robert Devereux 1 , Balwinder Sidhu 18 , Khuong Duy Hoang 16 , Justine Naylor 16 19
  1. Liverpool Hospital / South Western Sydney Clinical School, Wolli Creek, NSW, Australia
  2. Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
  3. Liverpool Hospital, Liverpool, NSW, Australia
  4. School of Physiotherapy, University of Sydney, Sydney, NSW, Australia
  5. Fairfield Hospital, Fairfield, NSW, Australia
  6. School of Population Health, UNSW Sydney, Sydney, NSW, Australia
  7. UNSW Sydney, Sydney, NSW, Australia
  8. IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
  9. Translational Health Research Institute, Western Sydney University, Campelltown, NSW, Australia
  10. South Western Sydney Local Health District, Sydney, NSW, Australia
  11. School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
  12. Department of Pharmacy, Prince of Wales Hospital, Sydney, NSW, Australia
  13. Monash University, Vic
  14. Alfred Hospital, Melbourne, VIC, Australia
  15. Sydney School of Health Sciences, University of Sydney, Sydney, NSW, Australia
  16. Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
  17. Peninsula Health, Frankston, VIC, Australia
  18. Multicultural Health Service, South Western Sydney Local Health District, Sydney, NSW, Australia
  19. UNSW Sydney, South Western Sydney Clinical School, Liverpool, NSW, Australia

Aims: In the context of often-prolonged hospitalisation following low-trauma hip fracture (LTHF), we sought to determine the feasibility of a targeted hospital-in-the-home program for these patients.

Methods: Prospective, quasi-experimental (consumer-choice) study at a tertiary metropolitan hospital, NSW, Australia. Eligibility: community-dwelling patients with LTHF, 22/7/24-30/11/24, planning rturn to the community. Intervention: a multidisciplinary early supported physical hospital discharge program (HITH4Hips); control: eligible but declined.

Primary feasibility and several secondary outcomes were mapped to elements of the RE-AIM framework: reach (characteristics, eligibility, consent), effectiveness (‘success rate’, length-of-stay [LOS; acute, and physical in-hospital], hospital-acquired complications [HACs], opioid consumption; patient-reported pain control, health-related quality of life [EQ-Today], falls efficacy, experience measures, health service use, medication costs), adoption (acceptability), implementation (carer burden, fidelity).

Results: Amongst 101 patients with LTHF, 32/101 remained HITH-eligible, 22/32 consented, 19 transferred onto HITH4Hips; 10 potentially eligible patients declined HITH4Hips. Overall, 18/19 HITH4Hips patients successfully remained in HITH; one patient experienced a fall, representing to hospital. Overall, 95% (18/19) patients reported HITH4Hips’ quality of treatment and care was good/very good. Carer burden was mostly reported as nil/low.

Mean number of days on HITH4Hips was 5.3 days (95% CI 4.0-6.6), mean difference total LOS (14.4 days, 95% CI 9.1-19.6) and physical ward bed LOS (20 days, 95% CI 14.9-24.8), favouring HITH4Hips. Daily opioid consumption was lower and EQ-Today scores higher amongst HITH patients.

Conclusions: This study met all feasibility thresholds, demonstrating potential reach/adoption/effectiveness/implementation of HITH4Hips for selected patients, supporting the need for large randomised controlled trials of early supported discharge after LTHF.