Stroke
Conditions
Keywords
stroke, telecare consultation
Brief summary
Since 2017, Hong Kong has provided post-acute stroke services in clinics operated by stroke advanced practice nurses (APNs). Currently, the applicability of the clinics has been further limited by the emergence of the coronavirus (COVID-19) pandemic due to restrictions on visits to the clinics and tightened social distancing requirements. Telecare consultations may be a viable option for contributing more flexible, interactive, and cost-efficient care models to support stroke survivors over the longer run. The present study takes advantage of this opportunity by utilizing implementation science to simultaneously implement and evaluate a telecare model of care in a nurse-led post-acute stroke clinic.
Interventions
PROCEDURETelecare consultation
Using Zoom to communicate with patients
PROCEDUREUsual face-to-face consultation
Face-to-face communication with patients
Sponsors
The Hong Kong Polytechnic University
The Queen Elizabeth Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* confirmed diagnosis of stroke within 1 month before enrolment, will be discharged home within a week, aged 18 or above, cognitively competent with a score equal to or greater than 22 in the Montreal Cognitive Assessment Hong Kong version, own a smartphone
Exclusion criteria
* have unaccompanied hearing or vision loss, cannot be reached by phone, bedbound, have no Internet connection at home, participating in other clinical trials at the same time, require physical contact, i.e. wound dressing
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Chang in Degree of disability after stroke | baseline, three months when the program is completed, three months after the program is completed. | Simplified modified Rankin scale will be used to measure the degree of disability for stroke patients. The scale has three questions to identify whether the patient has a score from 0 to 5, with higher scores representing higher degree of disability. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of the recurrence of stroke | baseline, three months when the program is completed, three months after the program is completed. | The percentage of participants who re-admitted to hospital because of recurrent stroke |
| Change of Quality of life, which measures an individual perception oftheir position in life. It includes physical and mental health. | baseline, three months when the program is completed, three months after the program is completed. | Quality of life will be measured using the Hong Kong version of EuroQol 5-dimension. The scale has five subdomains, which include mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. Since the scale has 5 items, each digit in the five digit codes refers to the status of each dimension, ranging from 1 for no problem, to 5 for sever problem. A higher scores indicate better quality of life. |
| Change of Post-stroke depression | baseline, three months when the program is completed, three months after the program is completed. | Post-stroke depression will be measured using the Chinese version of the Geriatric Depression scale. This scale has a minimum score of 0 and a maximum score of 15. Lower scores represent lower depression level. |
| Change of Medication adherence | baseline, three months when the program is completed, three months after the program is completed. | Medication adherence will be determined using the Adherence to Refills and Medications Scale. The scale produces an overall adherence score of 10-40, with lower scores indicating better adherence. |
| Change of Social participation | baseline, three months when the program is completed, three months after the program is completed. | Social participation will be measured using the 11-item Reintegration to Normal Living index. This scale is used to measure whether the patient has participated in several social activities before and after occurrence of stroke. The scale yields total score from 0-22, with higher scores indicating poorer social participation. |
| Number of attendances at a general practitioners' office, emergency department, hospital, and general out-patient clinic | baseline, three months when the program is completed, three months after the program is completed. | To measure the utilization of healthcare services by stroke patient before and after the intervention |
Countries
Hong Kong
Contacts
PRINCIPAL_INVESTIGATORArkers Wong, Ph.D.
The Hong Kong Polytechnic University
Outcome results
None listed