The CIVIC pilot trial: Community-based intervention to prevent serious complications following spinal cord injury in Bangladesh

Community-based care. Participants allocated to the Intervention group will be followed-up by telephone for two years after discharge. Community-based healthcare workers will telephone participants each fortnight in the first year and each month in the second year. They will encourage participants to contact healthcare workers at the first signs of complications or as needed for support. It is conservatively estimated that 20% of participants will not be contactable by telephone. These participants will be monitored with more frequent home visits. Each time the healthcare workers speak to participants, they will screen the participants for complications using purpose-designed interview scripts. Specifically, the healthcare workers will screen participants for the first indication of pressure ulcers, urinary tract infection, bowel impaction, bladder infection, depression, autonomic dysreflexia or respiratory complications. At the first indication of any of these complications, the healthcare workers will provide advice to participants and their families about management and then closely monitor them over the next few days or weeks until the complication is resolved. The healthcare workers will also visit participants and their families in their homes. There will be two home visits in the first year and one in the second year. Participants who cannot be contacted by telephone will be visited more frequently: three times in the first year and twice in the second year. At each home visit, the healthcare worker will assess the participant’s home situation and provide advice as needed.