A Novel Transition Program to Reduce Disability After Stroke (COMPASS)

The Washington University

Status: Completed

Conditions: Ischemic Stroke; Hemorrhagic Stroke

Treatments: Behavioral: Stroke education; Behavioral: COMPASS

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT03485820

201705047

1R01HD092398-01 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This study evaluates a program designed to help individuals transition home from inpatient rehabilitation following an ischemic or hemorrhagic stroke. Half of the participants will receive a stroke education program while the other half will receive an environmental modifications program.

Full description

A gap in care exists at the point of transition from inpatient rehabilitation (IR) to home, when survivors encounter new environmental barriers due to the cognitive and sensorimotor sequelae of stroke. Resolving these barriers and improving independence in the community have potential to significantly improve stroke survivors' long-term morbidity. The proposed study investigates the efficacy and safety of a novel enhanced rehabilitation-transition program to reduce environmental barriers and improve daily activity performance and community participation.

Enrollment: 185 patients

Sex: All

Ages: 50+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• aged ≥50 years
• acute ischemic or hemorrhagic stroke diagnosis
• independent ADLs prior to stroke (premorbid Modified Rankin Scale Score ≤2)
• plan to discharge to home

Exclusion criteria

• severe terminal systemic disease that limits life expectancy to < 6 months
• previous disorder (e.g. dementia) that makes interpretation of the self-rated scales difficult or Short Blessed Test (SBT) score of 10 or less (indicating significant cognitive impairment)
• moderate to severe Aphasia as determined by the NIHSS Best Language rating of 2 or more
• reside in congregate living facility.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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185 participants in 2 patient groups

COMPASS

Experimental group

Description:

COMPASS is a complex intervention that combines 2 evidence-based treatment strategies at a new point of care (transition from inpatient rehabilitation). The objective of home visits by an occupational therapy (OT) practitioner is to remediate barriers in the home and community that influence daily activities and community participation. The treatment will include a set of 1 predischarge and four 75-minute postdischarge visits. The intervention is followed by 2 booster sessions.

Treatment:

Behavioral: COMPASS

Education program

Sham Comparator group

Description:

An OT practitioner will deliver the program in accordance with "Evidence-Based Educational Guidelines for Stroke Survivors after Discharge Home." Topic order is determined by participants. Four 75-minute sessions will be provided. Topics may include stroke symptoms, risk factors and preventing stroke recurrence, nutrition, managing emotions, sleep, pain. Written materials from the National Stroke Association and the American Stroke Association are provided.

Treatment:

Behavioral: Stroke education