Document Type
Journal Article
Publication Title
BMJ Open
Volume
11
Issue
7
PubMed ID
34226214
Publisher
BMJ Publishing Group
School
School of Medical and Health Sciences
RAS ID
36253
Funders
National Health and Medical Research Council Australian Research Council National Heart Foundation of Australia
Grant Number
NHMRC Number : GNT1141561, GNT1063761ARC Number : DE200101494
Grant Link
http://purl.org/au-research/grants/nhmrc/GNT1141561 http://purl.org/au-research/grants/nhmrc/GNT1063761
Abstract
Introduction: After first stroke, the transition from rehabilitation to home can be confronting and fraught with challenges. Although stroke clinical practice guidelines recommend predischarge occupational therapy home visits to ensure safe discharge and provision of appropriate equipment, there is currently limited evidence to support this recommendation. Methods and analysis: The HOME Rehab trial is a national, multicentre, phase III randomised controlled trial with concealed allocation, blinded assessment and intention-to-treat analysis being conducted in Australia. The trial aim is to determine the effect and potential cost-effectiveness of an enhanced occupational therapy discharge planning intervention that involves pre and postdischarge home visits, goal setting and occupational therapy in the home (the HOME programme) in comparison to an in-hospital predischarge planning intervention. Stroke survivors aged ≥ 45 years, admitted to a rehabilitation ward, expected to return to a community (private) dwelling after discharge, with no significant prestroke disability will be randomly allocated 1:1 to receive a standardised discharge planning intervention and the HOME programme or the standardised discharge planning intervention alone. The primary outcome is participation measured using the Nottingham Extended Activities of Daily Living. Secondary outcome areas include hospital readmission, disability, performance of instrumental activities of daily living, health-related quality of life, quality of care transition and carer burden. Resources used/costs will be collected for the cost-effectiveness analysis and hospital readmission. Recruitment commenced in 2019. Allowing for potential attrition, 360 participants will be recruited to detect a clinically important treatment difference with 80% power at a two-tailed significance level of 0.05. Ethics and dissemination: This study is approved by the Alfred Health Human Research Ethics Committee and site-specific ethics approval has been obtained at all participating sites. Results of the main trial and the secondary endpoint of cost-effectiveness will be submitted for publication in peer-reviewed journals Trial registration number: ACTRN12618001360202
DOI
10.1136/bmjopen-2020-044573
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
Comments
Lannin, N. A., Clemson, L., Drummond, A., Stanley, M., Churilov, L., Laver, K., ... Cadilhac, D. A. (2021). Effect of occupational therapy home visit discharge planning on participation after stroke: Protocol for the HOME rehab trial. BMJ Open, 11(7), article e044573. https://bmjopen.bmj.com/content/11/7/e044573.abstract