Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/26996
Title: Effect of occupational therapy home visit discharge planning on participation after stroke: protocol for the HOME Rehab trial.
Austin Authors: Lannin, Natasha A;Clemson, Lindy;Drummond, Avril;Stanley, Mandy;Churilov, Leonid ;Laver, Kate;O'Keefe, Sophie;Cameron, Ian;Crotty, Maria;Usherwood, Tim;Andrew, Nadine E;Jolliffe, Laura;Cadilhac, Dominique A
Affiliation: Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
Department of General Practice, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Victoria, Australia
Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
Alfred Health, Melbourne, Victoria, Australia
Department of Occupational Therapy, Monash University, Melbourne, Victoria, Australia
The Florey Institute of Neuroscience and Mental Health
School of Health Sciences, University of Nottingham, Nottingham, Nottinghamshire, UK
Sydney School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
Melbourne Brain Centre at Royal Melbourne Hospital, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
Department of Rehabilitation, Aged and Extended Aged Care, College of Medicine and Public Heath, Flinders University, Adelaide, South Australia, Australia
Occupational Therapy, School of Allied Heath, College of Science Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
John Walsh Centre for Rehabilitation Research, The University of Sydney, Sydney, New South Wales, Australia
Flinders Clinical Effectiveness, School of Medicine, Flinders University, Adelaide, South Australia, Australia
The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
Issue Date: 5-Jul-2021
Date: 2021-07-05
Publication information: BMJ Open 2021; 11(7): e044573
Abstract: 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. 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. 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 journalsTrial registration numberACTRN12618001360202.
URI: https://ahro.austin.org.au/austinjspui/handle/1/26996
DOI: 10.1136/bmjopen-2020-044573
ORCID: 0000-0002-2066-8345
0000-0002-7958-5181
0000-0002-4846-2840
0000-0001-8162-682X
Journal: BMJ Open
PubMed URL: 34226214
Type: Journal Article
Subjects: rehabilitation medicine
Stroke
Stroke medicine
Appears in Collections:Journal articles

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