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. 2024 Aug 29;24(1):720.
doi: 10.1186/s12877-024-05277-7.

Implementation of a multimodal home-based rehabilitation intervention after discharge from inpatient geriatric rehabilitation (GeRas): an early qualitative process evaluation

Catharina Roth #  1 , Leonie Maier #  2 , Bastian Abel  3 , Patrick Roigk  3 , Kilian Rapp  3 , Oliver Schmidberger  3 , Martin Bongartz  4 , Simone Maier  4 , Isabel Wirth  5 , Brigitte Metz  5 , Désirée Immel  6 , Benjamin Finger  7 , Sabine Schölch  7 , Gisela Büchele  8 , Oliver Deuster  9 , Hans-Helmut Koenig  10 , Sophie Gottschalk  10 , Judith Dams  10 , William Micol  4 , Jürgen M Bauer  4 , Michel Wensing  2   11 , Petra Benzinger  4
Affiliations

Implementation of a multimodal home-based rehabilitation intervention after discharge from inpatient geriatric rehabilitation (GeRas): an early qualitative process evaluation

Catharina Roth et al. BMC Geriatr. .

Abstract

Background: Geriatric rehabilitation aims at increasing physical and social activity and maintaining the functional reserve of older people. However, the continuity of geriatric rehabilitation in the outpatient setting is limited due to a lack of structured aftercare programs. In order to overcome this, a three-month multimodal home-based intervention program (GeRas) was implemented. The aim of this early qualitative process evaluation was to assess GeRas in terms of perceived reach, effectiveness/efficacy, adoption/uptake, implementation, and maintenance/sustainability (Domains within the RE-AIM Framework) from the perspective of patients who received the intervention and healthcare providers who were involved in the delivery of the intervention.

Methods: In a qualitative process evaluation, 13 healthcare providers and 10 patients were interviewed throughout the beginning of the implementation period of GeRas to capture early experiences using a semi-structured interview guide. The interview guide and qualitative content analysis was guided by the RE-AIM Framework.

Results: The GeRas program was perceived to be largely well implemented and beneficial by healthcare providers and patients. According to healthcare providers, GeRas showed more advantages compared to usual care. Additionally, outcome expectations were mainly met (Domain 1: Effectiveness). However, the implementation of the intervention delivered via the eHealth system was perceived as challenging (Domain 2: Adoption). Nevertheless, the outpatient physical exercise, the outpatient counselling, and the continuous care after discharge improved perceived well-being regardless of the intervention type (Domain 3: Implementation). To facilitate the continued use of GeRas, technical requirements should be created to increase user-friendliness and to motivate patients to continue the training in the long term (Domain 4: Maintenance).

Conclusion: Although initial experiences with the implementation and effectiveness of GeRas were positive in general, organisational and technical issues need to be resolved to enhance sustainable and successful implementation of the GeRas program.

Trial registration: German Clinical Trials Register (DRKS00029559). Registered 5/10/2022.

Keywords: E-health; Geriatric rehabilitation; Post inhouse rehabilitation intervention; Telemedicine; Transitional care.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Representation of the data collection process of the qualitative process evaluation of the GeRas program. Green boxes refer to the data collection process of HCPs; yellow boxes refer to the data collection process of patients. The period between October 2022 and October 2023 is considered to be the first period of the implementation process of GeRas, it therefore represents the first experiences of HCPs and patients who participated in the GeRas program
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