The iCARE Study

The iCare research study is an integrated collection of educational modules for fracture and fall prevention which can be used by healthcare providers to pilot a Person- centered Routine Fracture Prevention Program (PREVENT). The aim of the iCare research study is to collaborate with long-term care (LTC) healthcare professionals, such as physicians, nurses, personal support workers, rehabilitation staff, and dietitians, to co-design and pilot the PREVENT Model.

This program aims to improve fracture prevention practices by increasing awareness and knowledge of fall and fracture management, ultimately reducing the risk of hip fractures among LTC residents. The PREVENT model outlines a series of Fracture Prevention Care Planning Recommendations which can be used and piloted by healthcare providers in LTC settings to reduce LTC home residents’ risk of fracture. LTC homes participating in the iCare study piloted the study educational materials and will implement the following care planning recommendations for: diet and supplements; multifactorial fracture and fall prevention strategies (i.e., hip protectors, exercise, review of environmental hazards and assistive devices); and a review of osteoporosis and other medications.

Before a trial can be implemented to determine the effectiveness of PREVENT in practice, we need to determine the feasibility of implementing PREVENT in practice and identify strategies to tailor the PREVENT program to the individual LTC home and care team through design thinking solutions. We hypothesize that co-designing a tailored PREVENT program with end-users may improve uptake and sustainability of the PREVENT program in LTC settings.

The primary outcome of the pilot study was to understand the feasibility of implementing PREVENT, for example by exploring recruitment rate, willingness and capacity of LTC homes to participate, and length of time to collect outcome data (among other measures). To date, the iCare educational modules have been piloted in one LTC home and three additional homes have been recruited to participate in the iCare study across Ontario. Based on the feedback provided by LTC home healthcare professionals, the researchers at Geras Centre adapted the program to increase feasibility of implementing the program in LTC homes. The iCare study will inform a larger trial (the PREVENT study) involving a total number of 122 LTC homes, set to begin in mid-2023, to explore the effectiveness of the PREVENT program and reduce the rate of hip fractures in LTC homes.