Patient Engagement Program for Stroke - Pilot Study (PEPS)

Currently there is a lot of literatures on stroke rehabilitation and post-discharge therapy. However, there are few evidence based guidelines on patient engagement after stroke in the post-rehabilitation community phase. There is evidence from stroke studies that stroke patients with mild to moderate disability, discharged early from an acute hospital unit can be rehabilitated in the community by an interdisciplinary stroke rehabilitation team and attain similar functional outcomes when compared to patients receiving in-patient rehabilitation. There is strong evidence that additional hospital based outpatient therapy improves short term functional outcomes compared to routine care over short term. Although meta-analyses have examined the efficacy of self management education programs, the interpretation of such reviews is limited by heterogeneity in populations and interventions and the limited range of outcomes measured. Few randomized controlled trials have found a reduction in health service utilization, such as incidences of hospitalization (in patients with chronic lung disease, heart disease, stroke and arthritis) as a direct outcome of attending an education program. For self-management support to be effective and sustainable in the community, it is postulated that initiatives simultaneously focus on supporting patients to engage in self management and equipping health care professionals with the necessary resources to assist them.

Study Overview

• Status: Unknown
• Conditions: Stroke; Rehabilitation
• Intervention / Treatment: Other: Patient Engagement Programme

Detailed Description

This is a randomized controlled pilot study of a post discharge community based patient engagement program for stroke patients discharged with a new carer after a period of in-hospital rehabilitation. Potential cases are identified within 2 weeks after admission into rehabilitation wards and randomized into either intervention group or usual care (control) group. Patients undergo the usual pre-discharge planning while in ward with predischarge assessment carried out by an independent (blinded) assessor. The control group are referred to receive the usual post-discharge community and rehabilitation backup. The intervention group has access to a special telephone hotline, home visits by team member within 1 week after discharge, patient diary to record home monitoring and back up of a specialist lead patient engagement clinic located in Kowloon Hospital. After 12 weeks, another home visit will be arranged for a repeat assessment by an independent (blinded) assessor. The outcomes to be measured include service parameters such as unplanned medical readmissions, AED attendances, length of stay at acute and rehabilitation units. Patient related parameters such as mortality, institutionalization, functional outcomes, mood, quality of life and complications will be measured as well as a carer strain and satisfaction survey.

• Study Type: Interventional
• Enrollment (Anticipated): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Hong Kong, China
    • Department of Rehabilitation, Kowloon Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• A stroke patient being discharged from a rehabilitation unit planned to be discharged to community with new carer

Exclusion Criteria:

• plan to enter institution within 3 months of discharge

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; usual care
Experimental: multidisciplinary intervention; Patient engagement Programme	Other: Patient Engagement Programme; Patient's Diary, Ad Hoc medical support and Ad Hoc Clinical admission, Early post discharge Home visit

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Length of hospital stay	3 months
Unplanned Medical readmissions	3 months
Emergency Department attendance rate	3 months

Secondary Outcome Measures

Outcome Measure	Time Frame
Barthel Index	3 months
Carer and Patient Satisfactory Survey	3 months
Carer Strain Index	3months
Medical complications	3 months
Functional Independence Measure	3 months
Modified Rivermead Mobility Index	3 months
Modified Ashworth Score	3 months
Geriatric Geriatric Depression Scale	3 months

Collaborators and Investigators

• Sponsor: Kowloon Hospital, Hong Kong
• Investigators: Principal Investigator: Mandy PM Fung, FHKCP, Department of Rehabilitaiton, Kowloon Hospital

Study record dates

Study Major Dates

• Study Start: May 1, 2010
• Primary Completion (Anticipated): December 1, 2010
• Study Completion (Anticipated): December 1, 2010

Study Registration Dates

• First Submitted: April 22, 2010
• First Submitted That Met QC Criteria: April 27, 2010
• First Posted (Estimate): April 28, 2010

Study Record Updates

• Last Update Posted (Estimate): April 28, 2010
• Last Update Submitted That Met QC Criteria: April 27, 2010
• Last Verified: March 1, 2010

More Information

Terms related to this study

• Keywords: stroke; patient engagement programme; community rehabilitation; new carer
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Stroke
• Other Study ID Numbers: PEPS