Interdisciplinary Team Approach to Stroke Rehabilitation in Home Care

McMaster University

Status: Completed

Conditions: Stroke

Treatments: Other: Interprofessional Team Approach

Study type: Interventional

Funder types: Other

Identifiers

NCT00463229

PHE-78692

Details and patient eligibility

About

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.

Full 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.

Enrollment: 101 patients

Sex: All

Volunteers: No Healthy Volunteers

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.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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101 participants in 2 patient groups

Interprofessional Team Approach

Experimental group

Description:

Participants in the experimental group will receive home care services from a team of professional service providers \[Community Care Access Centre (CCAC) Care Coordinator, Registered Nurse, Occupational therapist, Physiotherapist, Speech language pathologist, Nutritionist\] and non-professional service providers (personal support workers) with experience and training in stroke care. The team will provide a comprehensive, coordinated and evidence-based approach to stroke rehabilitation through weekly case conferencing, a written interdisciplinary care plan, and joint visits.

Treatment:

Other: Interprofessional Team Approach

Usual Home Care Services

No Intervention group

Description:

Participants allocated to the control group received standard home care services arranged by the CCAC. These include routine follow-up by the CCAC case manager whose focus is on assessment and referral to community agencies, and ongoing monitoring and evaluating the plan of care through in-home assessment with clients.