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Rehabilitation in a primary care setting for persons with chronic illness – a randomized controlled trial

  • Julie Richardson (a1), Lori Letts (a1), David Chan (a2), Paul Stratford (a1), Carri Hand (a1), David Price (a2), Linda Hilts (a2), Liliana Coman (a1), Mary Edwards (a1), Sue Baptiste (a1) and Mary Law (a1)...

The primary objective of this study was to determine whether adults with a chronic illness within a primary care setting who received a rehabilitation intervention in this setting showed greater improvement in health status and had fewer hospital admissions and emergency room visits compared with adults who do not receive the intervention.


More than half of Canadians (16 million people) live with chronic illness. Persons with chronic illness in primary care, especially older persons who are most at risk for functional decline, are currently not receiving effective management.


A randomized controlled trial was used. A rehabilitation multi-component intervention was delivered by a physiotherapist (PT) and occupational therapist in a primary care setting and included collaborative goal setting for rehabilitation needs, a six-week chronic disease self-management (SM) workshop, referral to community programs and a web-based education programme.


Three hundred and three patients participated, n = 152 intervention group and n = 151 in the control group. There was a significant difference between the groups for planned hospital days (F = 6.3, P = 0.00) with an adjusted difference 0.60 day per person, and increased satisfaction with rehabilitation services however no difference on health status or emergency room visits. This rehabilitation intervention which had a strong SM component prevented planned hospitalizations that resulted in a conservative estimated cost saving from reduced hospitalizations of $65 000. Future research needs to examine which patient groups with chronic illness show positive responses to rehabilitation and self-management.

Corresponding author
Correspondence to: Dr Julie Richardson, Associate Professor, School of Rehabilitation Science, McMaster University, IAHS 403, 1400 Main Street West, Hamilton, ON L8S 1C7, Canada. Email:
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Primary Health Care Research & Development
  • ISSN: 1463-4236
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