Clinical trial NCT00463229: Interdisciplinary Team Approach to Stroke Rehabilitation in Home Care
Official title: The Comparative Acceptability, Safety, Effects and Expense of Specialized, Integrated, and Interdisciplinary Community Rehabilitation for Stroke Survivors and Their Caregivers
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Stroke
Keywords: stroke
rehabilitation
home care services
effectiveness
quantitative research
interdisciplinary
cost
health services research, integrated
Lead sponsor: McMaster University
Sponsor class: OTHER
Collaborators: name: Canadian Institutes of Health Research (CIHR)
name: Ontario Ministry of Health and Long Term Care
name: Toronto Central Community Care Access Centre
name: Heart and Stroke Foundation of Ontario
name: Greater Toronto Area Rehabilitation Network
First posted: 2007-04-20
Enrollment: 101
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: As the population ages and the number of stroke survivors increases, information is needed to determine the best way of providing home care services for rehabilitation to stroke survivors and their caregivers while containing health care costs. This project will address this area by developing and testing the effects and costs of a collaborative and specialized team approach to stroke rehabilitation by health professionals, in a home care setting, compared to usual home care services. The overall goal of this way of providing home care services is to improve the quality of life and function of stroke survivors and their caregivers and prevent future strokes, which will reduce the overall cost to the health care system.

Detailed description: Stroke is the third leading cause of death in Canada, and is considered to be the most common disabling chronic condition. Approximately 40,000 to 50,000 people in Canada experience a stroke each year and about 80% of these people survive. Many of these people who survive a stroke never fully recover and are left with significant impairments and disabilities, and 12% to 25% will have another stroke within the first year. This results in a significant burden to individuals, families, and society as a whole. Of every 100 people who are hospitalized for a stroke, 15-40 return home and require home care services for rehabilitation. Stroke rehabilitation is one of the key components of stroke care. The goal of rehabilitation is to assist stroke survivors to reach his or her optimal level of physical, social, and emotional function.

Information gained from this study will be used to inform home care practice, policy decisions and the allocation of home care resources and make a national contribution to health care delivery reform.

Eligibility criteria: Inclusion Criteria:

* diagnosis of stroke or TIA has been confirmed.
* newly referred to and eligible for home care services (physiotherapy, speech language therapy, occupational therapy, nursing) through the Toronto Central CCAC.
* living at home in the community (outside of an institutional setting) up to 18-months post-stroke.
* English speaking

Exclusion Criteria:

* refuse to give informed consent.
* more than 18 months post-stroke at time of recruitment.
* unable to read/write English and an appropriate translator is not available.

Primary outcomes:
measure: Change Between the Value of the SF-36 Physical Function Score at 12 Months Minus Value at Baseline to Measure the Change in Health-related Quality of Life and Function
timeFrame: Baseline (pre-randomization) and 12 months
Secondary outcomes:
measure: Stroke Impact Scale - 16
timeFrame: Baseline (pre-randomization) and 12 months
measure: Reintegration to Normal Living Index
timeFrame: Baseline (pre-randomization) and 12 months
measure: Short Portable Mental Status Questionnaire.
timeFrame: Baseline (pre-randomization) and 12 months
measure: Centre for Epidemiological Studies in Depression Scale (CES-D)
timeFrame: Baseline and 12 months
measure: Personal Resource Questionnaire (PRQ85-Part Two)
timeFrame: Baseline (pre-randomization) and 12 months
measure: Kessler - 10
timeFrame: Baseline (pre-randomization) and 12 months
Other outcomes:
Locations:
city: Hamilton
country: Canada
facility: School of Nursing, McMaster University
state: Ontario
Study officials:
affiliation: McMaster University, School of Nursing
name: Maureen Markle-Reid, RN MScN PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Markle-Reid M, Orridge C, Weir R, Browne G, Gafni A, Lewis M, Walsh M, Levy C, Daub S, Brien H, Roberts J, Thabane L. Interprofessional stroke rehabilitation for stroke survivors using home care. Can J Neurol Sci. 2011 Mar;38(2):317-34. doi: 10.1017/s0317167100011537.