OBJECTIVE: We sought to evaluate whether comprehensive postdischarge care management for stroke survivors is superior to organized acute stroke department care with enhanced discharge planning in improving a profile of health and well-being. METHODS: This was a randomized trial of a comprehensive postdischarge care management intervention for patients with ischemic stroke and National Institutes of Health Stroke Scale scores greater than or equal to 1 discharged from an acute stroke department. An advanced practice nurse performed an in-home assessment for the intervention group from which an interdisciplinary team developed patient-specific care plans. The advanced practice nurse worked with the primary care physician and patient to implement the plan during the next 6 months. The intervention and usual care groups were compared using a global and closed hypothesis testing strategy. Outcomes fell into 5 domains: (1) neuromotor function, (2) institution time or death, (3) quality of life, (4) management of risk, and (5) stroke knowledge and lifestyle. RESULTS: Treatment effect was near 0 SD for all except the stroke knowledge and lifestyle domain, which showed a significant effect of the intervention (P = .0003). CONCLUSIONS: Postdischarge care management was not more effective than organized stroke department care with enhanced discharge planning in most domains in this population. The intervention did, however, fill a postdischarge knowledge gap.
RCT Entities:
OBJECTIVE: We sought to evaluate whether comprehensive postdischarge care management for stroke survivors is superior to organized acute stroke department care with enhanced discharge planning in improving a profile of health and well-being. METHODS: This was a randomized trial of a comprehensive postdischarge care management intervention for patients with ischemic stroke and National Institutes of Health Stroke Scale scores greater than or equal to 1 discharged from an acute stroke department. An advanced practice nurse performed an in-home assessment for the intervention group from which an interdisciplinary team developed patient-specific care plans. The advanced practice nurse worked with the primary care physician and patient to implement the plan during the next 6 months. The intervention and usual care groups were compared using a global and closed hypothesis testing strategy. Outcomes fell into 5 domains: (1) neuromotor function, (2) institution time or death, (3) quality of life, (4) management of risk, and (5) stroke knowledge and lifestyle. RESULTS: Treatment effect was near 0 SD for all except the stroke knowledge and lifestyle domain, which showed a significant effect of the intervention (P = .0003). CONCLUSIONS: Postdischarge care management was not more effective than organized stroke department care with enhanced discharge planning in most domains in this population. The intervention did, however, fill a postdischarge knowledge gap.
Authors: R L Sacco; E J Benjamin; J P Broderick; M Dyken; J D Easton; W M Feinberg; L B Goldstein; P B Gorelick; G Howard; S J Kittner; T A Manolio; J P Whisnant; P A Wolf Journal: Stroke Date: 1997-07 Impact factor: 7.914
Authors: Kyle R Allen; Susan Hazelett; David Jarjoura; Glenda C Wickstrom; K Hua; J Weinhardt; K Wright Journal: J Stroke Cerebrovasc Dis Date: 2002 Mar-Apr Impact factor: 2.136
Authors: Zhomart Orman; Amanda G Thrift; Muideen T Olaiya; David Ung; Dominique A Cadilhac; Thanh Phan; Mark R Nelson; Velandai K Srikanth; Jason Vuong; Christopher F Bladin; Richard P Gerraty; Sharyn M Fitzgerald; Judith Frayne; Joosup Kim Journal: Qual Life Res Date: 2022-01-24 Impact factor: 4.147
Authors: Bernadeta Bridgwood; Kate E Lager; Amit K Mistri; Kamlesh Khunti; Andrew D Wilson; Priya Modi Journal: Cochrane Database Syst Rev Date: 2018-05-07
Authors: Anne Forster; Lesley Brown; Jane Smith; Allan House; Peter Knapp; John J Wright; John Young Journal: Cochrane Database Syst Rev Date: 2012-11-14
Authors: Stefania Fugazzaro; Monica Denti; Monia Allisen Accogli; Stefania Costi; Donatella Pagliacci; Simona Calugi; Enrica Cavalli; Mariangela Taricco; Roberta Bardelli Journal: Int J Environ Res Public Health Date: 2021-05-31 Impact factor: 3.390
Authors: Liana S Cahill; Leeanne M Carey; Natasha A Lannin; Megan Turville; Cheryl L Neilson; Elizabeth A Lynch; Carol E McKinstry; Jia Xi Han; Denise O'Connor Journal: Cochrane Database Syst Rev Date: 2020-10-15