Forster, Anne, Young, John, Chapman, Katie, Nixon, Jane, Patel, Anita, Holloway, Ivana, Mellish, Kirste, Anwar, Shamaila, Breen, Rachel, Knapp, Martin 
ORCID: 0000-0003-1427-0215, Murray, Jenni and Farrin, Amanda
(2015)
Cluster randomized controlled trial.
Stroke, 46 (8).
pp. 2212-2219.
ISSN 0039-2499
Abstract
Background and Purpose—We developed a new postdischarge system of care comprising a structured assessment covering longer-term problems experienced by patients with stroke and their carers, linked to evidence-based treatment algorithms and reference guides (the longer-term stroke care system of care) to address the poor longer-term recovery experienced by many patients with stroke. Methods—A pragmatic, multicentre, cluster randomized controlled trial of this system of care. Eligible patients referred to community-based Stroke Care Coordinators were randomized to receive the new system of care or usual practice. The primary outcome was improved patient psychological well-being (General Health Questionnaire-12) at 6 months; secondary outcomes included functional outcomes for patients, carer outcomes, and cost-effectiveness. Follow-up was through self-completed postal questionnaires at 6 and 12 months. Results—Thirty-two stroke services were randomized (29 participated); 800 patients (399 control; 401 intervention) and 208 carers (100 control; 108 intervention) were recruited. In intention to treat analysis, the adjusted difference in patient General Health Questionnaire-12 mean scores at 6 months was −0.6 points (95% confidence interval, −1.8 to 0.7; P=0.394) indicating no evidence of statistically significant difference between the groups. Costs of Stroke Care Coordinator inputs, total health and social care costs, and quality-adjusted life year gains at 6 months, 12 months, and over the year were similar between the groups. Conclusions—This robust trial demonstrated no benefit in clinical or cost-effectiveness outcomes associated with the new system of care compared with usual Stroke Care Coordinator practice.
| Item Type: | Article |
|---|---|
| Official URL: | http://stroke.ahajournals.org/ |
| Additional Information: | © 2015 Bradford Teaching Hospitals NHS Foundation Trust |
| Divisions: | Care Policy and Evaluation Centre |
| Subjects: | R Medicine > RA Public aspects of medicine |
| Date Deposited: | 11 Sep 2015 14:49 |
| Last Modified: | 12 Dec 2024 00:56 |
| URI: | http://eprints.lse.ac.uk/id/eprint/63519 |
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