Telecare Consultation in Nurse-led Post-acute Stroke Clinic

Not Applicable

Completed

• Conditions: Stroke
• Interventions: Device: telecare consultation

• Registration Number: NCT05081570
• Lead Sponsor: The Hong Kong Polytechnic University

Brief Summary

Introduction: The progress of stroke recovery is slow and enduring. If stroke survivors are not properly managed to facilitate their rehabilitation after discharged from hospital, their risk for recurrence after an index stroke will be very high. Globally, nurse-led post-acute stroke clinics have been developed to provide tertiary care services to support stroke survivors. While synthesized evidence supports the idea that the post-stroke services delivered by nurses in the clinic can improve the functional ability and reduce the readmission rate, shortcomings of these services such as compulsory traveling time and cost, long waiting time at the clinic, and the pandemic situation limit the clinic utilization by stroke survivors. Telecare consultation is a new modality aiming to provide a new healthcare access experience to the public, though how it can be applied in nurse-led clinic and what effects it can bring about on post-stroke survivors has not been reported.

Detailed Description

The aim of this pilot study is to determine the feasibility and effectiveness of telecare consultation in nurse-led post-acute stroke clinic.

Method: The present pilot study adopts a one-group pre-test post-test design. The potential subjects will be recruited from the clinic in Queen Elizabeth Hospital if they are (1) having a confirmed diagnosis of stroke within 1 month before enrolment, (2) referred to nurse-led post-acute stroke clinic, (3) aged 18 or above, (4) cognitively competent with a score ≥ 22 in the Montreal Cognitive Assessment Hong Kong version, (5) living at home before and after discharged from the acute stroke unit, and (6) having a smartphone or living with family member who has a smartphone. The participants will receive two tertiary stroke care consultations provided by stroke nurses via telecare in 2 months. The outcome measures include feasibility (reasons for refusal and drop-out, acceptance and satisfaction of both the advanced practising nurses and their patients towards the program), and effectiveness (degree of disability after stroke, activity of daily living, instrumental activity of daily living, health-related quality of life, depression). Data will be collected at pre- (T1) and post- (T2) intervention.

Discussion: The findings of this pilot study can provide a preliminary evidence on the use of telecare consultation in the nurse-led post-acute stroke clinic including its feasibility and effectiveness on both providers and patients. When gaps are identified, they could be adjusted to help develop and design a definitive, large-scale randomized controlled trial.

Study Timeline

• Study First Submitted: 2021-10-06
• Study First Submitted QC: 2021-10-06
• Study First Posted: 2021-10-18
• Study Start: 2021-10-30
• Primary Completion: 2023-07-30
• Study Completion: 2023-07-30
• Status Verified: 2023-09
• Last Update Submitted: 2023-09-20
• Last Update Posted: 2023-09-22

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 78

Inclusion Criteria

• confirmed diagnosis of stroke within 1 month before enrolment
• will be discharged home within a week
• aged 18 or above
• cognitively competent with a score equal to or greater than 22 in the Montreal Cognitive Assessment Hong Kong version
• own a smartphone

Exclusion Criteria

• have unaccompanied hearing or vision loss
• cannot be reached by phone
• bedbound
• no Internet connection at home
• participating in other clinical trials at the same time
• require physical contact, i.e. wound dressing

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Intervention group	telecare consultation	The participants will receive two tertiary stroke care consultations provided by stroke nurses via telecare in 2 months.

Primary Outcome Measures

Name	Time	Method
Degree of disability after stroke	baseline, three months when the program is completed	Simplified modified Rankin scale will be used to measure the degree of disability for stroke patients.

Secondary Outcome Measures

Name	Time	Method
Quality of life	baseline, three months when the program is completed	Quality of life will be measured using the Hong Kong version of EuroQol 5-dimension (EQ-5D-5L).
Post-stroke depression	baseline, three months when the program is completed	Post-stroke depression will be measured using the Chinese version of the Geriatric Depression Scale
Medication adherence	baseline, three months when the program is completed	Medication adherence will be determined using the Adherence to Refills and Medications Scale (ARMS).
Social participation	baseline, three months when the program is completed	Social participation will be measured using the 11-item Reintegration to Normal Living Index. This scale is used to measure whether the patient has participated in several social activities before and after occurrence of stroke.
Number of attendances at a general practitioner's office, emergency department, hospital, and general out-patient clinic	baseline, three months when the program is completed	To measure the utilization of healthcare services by stroke patient before and after the intervention.

Trial Locations

Locations (1)

Queen Elizabeth Hospital; 🇭🇰 Kowloon, Hong Kong