Early home-supported discharge for patients with stroke in Portugal: a randomised controlled trial

Santana, S., Rente, J., Neves, C., Redondo, P., Szczygiel, N., Larsen, T., Jepsen, B. and Langhorne, P. (2017) Early home-supported discharge for patients with stroke in Portugal: a randomised controlled trial. Clinical Rehabilitation, 31(2), pp. 197-206. (doi: 10.1177/0269215515627282) (PMID:26837431)

Abstract

Objective: To evaluate an early home-supported discharge service for stroke patients. Design: We carried out a prospective, randomised, open-label, blinded-endpoint trial (allocation ratio of 1:1) with patients assigned to either an early home-supported discharge service or usual care. Setting: The study was undertaken in Aveiro, Portugal, between April 2009 and April 2013. Subjects: We included stroke patients aged 25–85 years admitted to the stroke unit with an initial Functional Independence Measure of up to 100, who gave informed consent. Interventions: Patients in the early home-supported discharge group began their rehabilitation intervention in the stroke unit and the early home-supported discharge team worked with them at home for a maximum of one month. Patients in the control group received usual services. Main measures: The primary outcome measure was the Functional Independence Measure at six months after stroke. Results: We randomised 190 patients of whom 34 were lost to follow-up. There were no significant differences (p > 0.5) in the average scores of Functional Independence Measure between the early home-supported discharge (69 ±22; mean ±SD) and the control groups (71 ±17) measured at baseline; and between the early home-supported discharge (107 ±20) and the control groups (107 ±25) measured at six months. The number of individuals with a low Functional Independence Measure score (<60) in the early home-supported discharge group compared with the control group was higher at admission (34/95 vs. 26/95) and lower at follow-up (2/74 vs. 5/78). Conclusions: It was feasible to implement early home-supported discharge procedures in a Southern European setting, but we have not shown convincing differences in disability at six months.

• Item Type: Articles
• Additional Information: This work has been funded by the European Commission [FP7-Homecare 222954]. NS was partially supported by FCT – the Portuguese Foundation for Science and Technology PhD [grant number SFRH/BD/69892/2010].
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Langhorne, Professor Peter
• Authors: Santana, S., Rente, J., Neves, C., Redondo, P., Szczygiel, N., Larsen, T., Jepsen, B., and Langhorne, P.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Clinical Rehabilitation
• Publisher: SAGE Publications
• ISSN: 0269-2155
• ISSN (Online): 1477-0873
• Published Online: 02 February 2016
• Copyright Holders: Copyright © 2016 The Authors
• First Published: First published in Clinical Rehabilitation 31(2): 197-206
• Publisher Policy: Reproduced under a Creative Commons License