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

• Published in: Clinical rehabilitation 2017-02, Vol.31 (2), p.197-206
• Main Authors: Santana, Silvina, Rente, José, Neves, Conceição, Redondo, Patrícia, Szczygiel, Nina, Larsen, Torben, Jepsen, Birgitte, Langhorne, Peter
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Adult; Aged; Clinical trials; Continuity of care; Continuity of Patient Care - organization & administration; Control groups; Disability; Discharge; Early intervention; Evaluative Studies; Evidence-based medicine; Home Care Services - organization & administration; Home health care; Humans; Informed consent; Middle Aged; Mobility; Outcome Assessment (Health Care); Patient admissions; Patient Discharge; Prognosis; Prospective Studies; Recovery of Function; Rehabilitation; Risk Assessment; Severity of Illness Index; Single-Blind Method; Stroke; Stroke - diagnosis; Stroke Rehabilitation - methods; Teams
• ISSN: 0269-2155; 1477-0873
• DOI: 10.1177/0269215515627282

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 (