Improving Post-acute Stroke Follow-up Care by Adopting Telecare Consultations in a Nurse-led Clinic During COVID-19 and Beyond: A Hybrid Type 2 Implementation-effectiveness Randomized Trial
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 196
- Locations
- 2
- Primary Endpoint
- Chang in Degree of disability after stroke
Study Overview
Brief Summary
Since 2017, Hong Kong has provided post-acute stroke services in clinics operated by stroke advanced practice nurses (APNs). Currently, the applicability of the clinics has been further limited by the emergence of the coronavirus (COVID-19) pandemic due to restrictions on visits to the clinics and tightened social distancing requirements. Telecare consultations may be a viable option for contributing more flexible, interactive, and cost-efficient care models to support stroke survivors over the longer run. The present study takes advantage of this opportunity by utilizing implementation science to simultaneously implement and evaluate a telecare model of care in a nurse-led post-acute stroke clinic.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Health Services Research
- Masking
- Single (Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
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, have no Internet connection at home, participating in other clinical trials at the same time, require physical contact, i.e. wound dressing
Arms & Interventions
Intervention group
Participants will receive three tertiary stroke care consultations provided by stroke nurses via telecare in 3 months.
Intervention: Telecare consultation (Procedure)
Control group
Participants will receive three usual face-to-face consultations provided by stroke nurses in 3 months
Intervention: Usual face-to-face consultation (Procedure)
Outcomes
Primary Outcomes
Chang in Degree of disability after stroke
Time Frame: baseline, three months when the program is completed, three months after the program is completed.
Simplified modified Rankin scale will be used to measure the degree of disability for stroke patients. The scale has three questions to identify whether the patient has a score from 0 to 5, with higher scores representing higher degree of disability.
Secondary Outcomes
- Incidence of the recurrence of stroke(baseline, three months when the program is completed, three months after the program is completed.)
- Change of Quality of life, which measures an individual perception oftheir position in life. It includes physical and mental health.(baseline, three months when the program is completed, three months after the program is completed.)
- Change of Post-stroke depression(baseline, three months when the program is completed, three months after the program is completed.)
- Change of Medication adherence(baseline, three months when the program is completed, three months after the program is completed.)
- Change of Social participation(baseline, three months when the program is completed, three months after the program is completed.)
- Number of attendances at a general practitioners' office, emergency department, hospital, and general out-patient clinic(baseline, three months when the program is completed, three months after the program is completed.)
Investigators
Arkers, Wong
Assistant professor
The Hong Kong Polytechnic University