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
NCT12618001360202
Funder
National
Health and Medical Research Council
National
Heart Foundation of Australia
Australian
Research Council
Cited by
1 articles.
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