TY - JOUR
T1 - Bridging the gap
T2 - The effectiveness of teaming a stroke coordinator with patient's personal physician on the outcome of stroke
AU - Mayo, Nancy E.
AU - Nadeau, Lyne
AU - Ahmed, Sara
AU - White, Carole
AU - Grad, Roland
AU - Huang, Allen
AU - Yaffe, Mark J.
AU - Wood-Dauphinee, Sharon
PY - 2008/1
Y1 - 2008/1
N2 - Objectives: to test the hypothesis as to whether persons newly discharged into the community following an acute stroke and assigned a stroke case manager would experience, compared to usual post-hospital care, better health-related quality of life (HRQL), fewer emergency room visits and less non-elective hospitalisations. Design: a stratified, balanced, evaluator-blinded, randomised clinical trial. Setting: five university-affiliated acute-care hospitals in Montreal, Quebec, Canada. Participants: persons (n=190) returning home directly from the acute-care hospital following a first or recurrent stroke with a need for health care supervision post-discharge because of low function, co-morbidity, or isolation. Intervention: for 6 weeks following hospital discharge a nurse stroke care manager maintained contact with patients through home visits and telephone calls designed to coordinate care with the person's personal physician and link the stroke survivor into community-based stroke services. Measurements: the primary outcome was the Physical Component Summary (PCS) of the Short-Form (SF)-36 survey. A secondary outcome was utilisation of health services. Also measured was the impact of stroke on functioning. Measurements were made at hospital discharge (baseline), following the 6-week intervention and at 6-months post-stroke. Results: the average age of the participants was 70 years. Discharge was achieved on average 12 days post-stroke and most participants had had a stroke of moderate severity. There were no differences between groups on the primary outcome measure, health services utilisation, or any of the secondary outcome measures. Conclusion: for this population, there was no evidence that this type of passive case management inferred any added benefit in terms of improvement in health-related quality of life or reduction in health services utilisation and stroke impact, than usual post-discharge management.
AB - Objectives: to test the hypothesis as to whether persons newly discharged into the community following an acute stroke and assigned a stroke case manager would experience, compared to usual post-hospital care, better health-related quality of life (HRQL), fewer emergency room visits and less non-elective hospitalisations. Design: a stratified, balanced, evaluator-blinded, randomised clinical trial. Setting: five university-affiliated acute-care hospitals in Montreal, Quebec, Canada. Participants: persons (n=190) returning home directly from the acute-care hospital following a first or recurrent stroke with a need for health care supervision post-discharge because of low function, co-morbidity, or isolation. Intervention: for 6 weeks following hospital discharge a nurse stroke care manager maintained contact with patients through home visits and telephone calls designed to coordinate care with the person's personal physician and link the stroke survivor into community-based stroke services. Measurements: the primary outcome was the Physical Component Summary (PCS) of the Short-Form (SF)-36 survey. A secondary outcome was utilisation of health services. Also measured was the impact of stroke on functioning. Measurements were made at hospital discharge (baseline), following the 6-week intervention and at 6-months post-stroke. Results: the average age of the participants was 70 years. Discharge was achieved on average 12 days post-stroke and most participants had had a stroke of moderate severity. There were no differences between groups on the primary outcome measure, health services utilisation, or any of the secondary outcome measures. Conclusion: for this population, there was no evidence that this type of passive case management inferred any added benefit in terms of improvement in health-related quality of life or reduction in health services utilisation and stroke impact, than usual post-discharge management.
KW - Case management
KW - Co-morbidity
KW - Elderly
KW - Health services research
KW - Quality of life
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=38549110663&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=38549110663&partnerID=8YFLogxK
U2 - 10.1093/ageing/afm133
DO - 10.1093/ageing/afm133
M3 - Article
C2 - 18006510
AN - SCOPUS:38549110663
SN - 0002-0729
VL - 37
SP - 32
EP - 38
JO - Age and ageing
JF - Age and ageing
IS - 1
ER -