Clinical trial NCT05081570: Telecare Consultation in Nurse-led Post-acute Stroke Clinic
Official title: A Pilot Study to Evaluate the Feasibility and Effectiveness of Telecare Consultation in Nurse-led Post-acute Stroke Clinic
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Stroke
Keywords: stroke
telecare consultation
nurse clinic
Lead sponsor: The Hong Kong Polytechnic University
Sponsor class: OTHER
Collaborators: name: The Queen Elizabeth Hospital
First posted: 2021-10-18
Enrollment: 78
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: SUPPORTIVE_CARE

Brief summary: Introduction: The progress of stroke recovery is slow and enduring. If stroke survivors are not properly managed to facilitate their rehabilitation after discharged from hospital, their risk for recurrence after an index stroke will be very high. Globally, nurse-led post-acute stroke clinics have been developed to provide tertiary care services to support stroke survivors. While synthesized evidence supports the idea that the post-stroke services delivered by nurses in the clinic can improve the functional ability and reduce the readmission rate, shortcomings of these services such as compulsory traveling time and cost, long waiting time at the clinic, and the pandemic situation limit the clinic utilization by stroke survivors. Telecare consultation is a new modality aiming to provide a new healthcare access experience to the public, though how it can be applied in nurse-led clinic and what effects it can bring about on post-stroke survivors has not been reported.

Detailed description: The aim of this pilot study is to determine the feasibility and effectiveness of telecare consultation in nurse-led post-acute stroke clinic.

Method: The present pilot study adopts a one-group pre-test post-test design. The potential subjects will be recruited from the clinic in Queen Elizabeth Hospital if they are (1) having a confirmed diagnosis of stroke within 1 month before enrolment, (2) referred to nurse-led post-acute stroke clinic, (3) aged 18 or above, (4) cognitively competent with a score ≥ 22 in the Montreal Cognitive Assessment Hong Kong version, (5) living at home before and after discharged from the acute stroke unit, and (6) having a smartphone or living with family member who has a smartphone. The participants will receive two tertiary stroke care consultations provided by stroke nurses via telecare in 2 months. The outcome measures include feasibility (reasons for refusal and drop-out, acceptance and satisfaction of both the advanced practising nurses and their patients towards the program), and effectiveness (degree of disability after stroke, activity of daily living, instrumental activity of daily living, health-related quality of life, depression). Data will be collected at pre- (T1) and post- (T2) intervention.

Discussion: The findings of this pilot study can provide a preliminary evidence on the use of telecare consultation in the nurse-led post-acute stroke clinic including its feasibility and effectiveness on both providers and patients. When gaps are identified, they could be adjusted to help develop and design a definitive, large-scale randomized controlled trial.

Eligibility criteria: Inclusion Criteria:

* confirmed diagnosis of stroke within 1 month before enrolment
* will be discharged home within a week
* aged 18 or above
* cognitively competent with a score equal to or greater than 22 in the Montreal Cognitive Assessment Hong Kong version
* own a smartphone

Exclusion Criteria:

* have unaccompanied hearing or vision loss
* cannot be reached by phone
* bedbound
* no Internet connection at home
* participating in other clinical trials at the same time
* require physical contact, i.e. wound dressing

Primary outcomes:
measure: Degree of disability after stroke
timeFrame: baseline, three months when the program is completed
Secondary outcomes:
measure: Quality of life
timeFrame: baseline, three months when the program is completed
measure: Post-stroke depression
timeFrame: baseline, three months when the program is completed
measure: Medication adherence
timeFrame: baseline, three months when the program is completed
measure: Social participation
timeFrame: baseline, three months when the program is completed
measure: Number of attendances at a general practitioner's office, emergency department, hospital, and general out-patient clinic
timeFrame: baseline, three months when the program is completed
Other outcomes:
measure: Number of patients who are eligible, excluded, recruited, and completed.
timeFrame: three months when the program is completed
measure: IT literacy
timeFrame: baseline, three months when the program is completed
measure: the success of the adoption of telecare consultation
timeFrame: three months when the program is completed
Locations:
city: Kowloon
country: Hong Kong
facility: Queen Elizabeth Hospital
Study officials:
affiliation: The Hong Kong Polytechnic University
name: Arkers Wong, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References: