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Occupational therapy pre-discharge HOme VIsits for patients with a Stroke (HOVIS): results of a randomised controlled trial

Drummond, A.E.R.; Whitehead, P.; Fellows, K.; Sprigg, Nikola; Sampson, Christopher James; Edwards, Claire; Lincoln, Nadina

Authors

A.E.R. Drummond Avril.Drummond@nottingham.ac.uk

P. Whitehead Phillip.J.Whitehead@nottingham.ac.uk

K. Fellows karen.fellows@nhs.net

Nikola Sprigg Nikola.Sprigg@nottingham.ac.uk

Christopher James Sampson chris.sampson@nottingham.ac.uk

Claire Edwards Claire.Edwards@nottingham.ac.uk

Nadina Lincoln Nadina.Lincoln@nottingham.ac.uk

Abstract

Objective
To conduct a randomised controlled trial (RCT) of occupational therapy predischarge home visits for people after stroke in order to assess the feasibility of a definitive trial.
Design
Two studies; a randomised controlled trial and a cohort study. We randomised eligible patients for whom there was clinical uncertainty about the need to conduct a home visit in to an RCT; patients for whom a visit was deemed ‘essential’, were enrolled into a cohort study.
Setting
Stroke rehabilitation unit of teaching hospital Participants 126 participants hospitalised following recent stroke. Interventions Pre-discharge home visit with an occupational therapist or structured hospital based interview with occupational therapist.
Main outcome measures
The primary objective was to collect information on the feasibility of an RCT, including eligibility criteria, consent procedures, control intervention, and outcome assessments. The primary outcome measure was the Nottingham Extended Activities of Daily Living scale (NEADL) at one month after
discharge from hospital. Secondary outcomes were measures of activities of daily living, mood, quality of life and costs at one week and one month following discharge.
Results
Ninety- three people were allocated to the RCT. Of these 47 were randomised to intervention and 46 to the control. Thirty-three patients were enrolled into the cohort study and received a home visit. Forty-one (87%) participants in the RCT intervention group and 29 (88%) participants in the cohort study received the intervention. There were no significant differences in outcome between the groups in the RCT for the primary outcome measure (performance in extended activities of daily living) at one month. The average cost of a home visit was £208 (£183 for those in the RCT and £243 for those in the cohort study). The average cost of the interview for the control group was £75.
Conclusion
Our main finding was that recruitment to the trial was feasible and no safety issues were raised. A trial is warranted given the resource implications of pre- discharge occupational therapy home visits.

Journal Article Type Article
Publication Date Oct 31, 2012
Journal Clinical Rehabilitation
Print ISSN 0269-2155
Electronic ISSN 1477-0873
Publisher SAGE Publications
Peer Reviewed Not Peer Reviewed
Institution Citation Drummond, A., Whitehead, P., Fellows, K., Sprigg, N., Sampson, C. J., Edwards, C., & Lincoln, N. (2012). Occupational therapy pre-discharge HOme VIsits for patients with a Stroke (HOVIS): results of a randomised controlled trial. Clinical Rehabilitation, doi:10.1177/0269215512462145. ISSN 0269-2155
DOI https://doi.org/10.1177/0269215512462145
Keywords Activities of daily living; occupational therapy; stroke; home visit;
Publisher URL http://cre.sagepub.com/content/early/2012/10/31/0269215512462145
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf
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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf




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