Clinical trial NCT05875389: Virtual Intervention Stroke Initiative
Official title: Virtual Intervention Stroke Initiative by Ottawa Neurology
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Ischemic Stroke
Acute Ischemic Stroke
Keywords: telemedicine
virtual care
Lead sponsor: Ottawa Hospital Research Institute
Sponsor class: OTHER
Collaborators: name: The Ottawa Hospital Academic Medical Association
First posted: 2023-05-25
Enrollment: 80
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The goal of this clinical trial is to determine if patients admitted to a primary stroke centre, such as the general internal medicine service of the Ottawa Hospitals General Campus, for acute ischemic stroke would benefit from a scheduled virtual assessment with a stroke neurologist to review investigations, results, and evaluations to identify stroke etiology, propose appropriate therapy, and guide decision-making and multidisciplinary assessment, similar to services provided to patients admitted to comprehensive stroke centres, such as the Civic Campus of the Ottawa Hospital.

Detailed description: Patients admitted to primary stroke centres do not have access to the same level of stroke expertise on site as do patients admitted to comprehensive stroke centres, resulting in increased length of stay with implications for access to stroke rehabilitation. Virtual access to stroke experts has been used in hyperacute stroke care through programs such as Ontario Telestroke, but this has not been routinely used for acute inpatient management. The investigators propose a system to provide virtual access to the stroke neurology team to patients admitted with stroke in a primary stroke centre. Patients at the General Campus of the Ottawa Hospital are currently admitted to Internal Medicine; this includes scheduled virtual assessment with a stroke neurologist and advanced practice nurse/interdisciplinary support to review investigations, results, and evaluations to identify stroke etiology, propose appropriate therapy, and guide decision-making and multidisciplinary assessment, similar to services provided to patients admitted to the Civic Campus. This will be developed with the assistance of Internal Medicine and will utilize technologies and assessment tools and strategies already being used for provision of virtual care in other settings. The goal of this project will be to prove that patients in primary stroke centres, with the assistance of virtual care, can benefit from the expertise available at comprehensive centers throughout their stay, and that this will result in an improved quality of care with benefits for patients, hospitals, and the community.

Eligibility criteria: Inclusion Criteria:

* 18 years of age or older
* admitted to the general internal medicine service of the Ottawa Hospital General Campus for acute ischemic stroke
* able to participate in video assessments with necessary accommodation/facilitation for participation (particularly if stroke results in physical or communication deficits)

Exclusion Criteria:

* patients who are unable, in the judgement of the study team or treating team, to participate in video assessments

Primary outcomes:
measure: Morbidity-adjusted length of stay
timeFrame: Through study completion, an average of 6 months
Secondary outcomes:
measure: Length of time on ALC
timeFrame: Through study completion, an average of 6 months
Other outcomes:
measure: Discharge destination
timeFrame: Over 6 months
measure: Functional outcome
timeFrame: Over 6 months
measure: Home time
timeFrame: Over 6 months
Locations:
Study officials:
References: