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Title: Exploring post acute rehabilitation service use and outcomes for working age stroke survivors (≤65 years) in Australia, UK and South East Asia: data from the international AVERT trial.
Austin Authors: Walters, Rosy;Collier, Janice M;Braighi Carvalho, Lillian;Langhorne, Peter;Katijjahbe, Md Ali;Tan, Dawn;Moodie, Marj;Bernhardt, Julie
Affiliation: Academic Section of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
Stroke, Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
Physiotherapy, Royal Free London NHS Foundation Trust, London, UK
Deakin Health Economics, Deakin University, Burwood, Victoria, Australia
Physiotherapy, Hospital Canselor Tuanku Muhriz, Pusat Perubatan UKM, Cheras, Kuala Lumpur, Malaysia
Faculty of Health, Art and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
Department of Physiotherapy, Singapore General Hospital, Singapore
Issue Date: 11-Jun-2020 2020-06-11
Publication information: BMJ Open 2020; 10(6): e035850
Abstract: Information about younger people of working age (≤65 years), their post stroke outcomes and rehabilitation pathways can highlight areas for further research and service change. This paper describes: (1) baseline demographics; (2) post acute rehabilitation pathways; and (3) 12-month outcomes; disability, mobility, depression, quality of life, informal care and return to work of working age people across three geographic regions (Australasia (AUS), South East (SE) Asia and UK). This post hoc descriptive exploration of data from the large international very early rehabilitation trial (A Very Early Rehabilitation Trial (AVERT)) examined the four common post acute rehabilitation pathways (inpatient rehabilitation, home with community rehabilitation, inpatient rehabilitation then community rehabilitation and home with no rehabilitation) experienced by participants in the 3 months post stroke and describes their 12-month outcomes. Hospital stroke units in AUS, UK and SE Asia. Patients who had an acute stroke recruited within 24 hours who were ≤65 years. 668 participants were ≤65 years; 99% lived independently, and 88% no disability (modified Rankin Score (mRS)=0) prior to stroke. We had complete data for 12-month outcomes for n=631 (94%). The proportion receiving inpatient rehabilitation was higher in AUS than other regions (AUS 52%; UK 25%; SE Asia 23%), whereas the UK had higher community rehabilitation (UK 65%; AUS 61%; SE Asia 39%). At 12 months, 70% had no or little disability (mRS 0-2), 44% were depressed, 28% rated quality of life as poor or worse than death. For those working prior to stroke (n=228), only 57% had returned to work. A noteworthy number of working age survivors received no rehabilitation services within 3 months post stroke. There was considerable variation in rehabilitation pathways and post acute service use across the three regions. At 12 months, there were high rates of depression, poor quality of life and low rates of return to work. Australian New Zealand Clinical Trials Registry (ACTRN12606000185561).
DOI: 10.1136/bmjopen-2019-035850
ORCID: 0000-0002-3927-2666
Journal: BMJ Open
PubMed URL: 32532772
Type: Journal Article
Subjects: international
rehabilitation services
return to work
young Stroke
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