Effects of a transitional home-based care program for stroke survivors in Harbin, China: a randomized controlled trial

Yuet Wong, Frances Kam, Wang, Shao Ling, Ng, Shamay S.M., Lee, Paul H., Ching Wong, Arkers Kwan, Li, Haiyan, Wang, Wei, Wu, Lijie, Zhang, Yi and Shi, Yangyang (2022) Effects of a transitional home-based care program for stroke survivors in Harbin, China: a randomized controlled trial. Age and Ageing, 51 (2), [afac027]. (doi:10.1093/ageing/afac027).

Abstract

Background: China has the biggest stroke burden in the world. Continued measures have been taken to enhance post-stroke rehabilitation management in the last two decades. The weak link is with home-based rehabilitation, with more attention and resources devoted to inpatient rehabilitation. Objective: to address the service gap, this study tested a home-based transitional care model for stroke survivors. Methods: a randomized controlled trial was conducted from February 2019 to May 2020 in Harbin, China, involving 116 patients with ischemic stroke. The intervention group participants (n = 58, 50%) received a 12-week home-based care program with components of transitional care measures and the national guidelines for facilitating patients to perform home-based exercises with continued monitoring and gradual progression. Control group participants received standard care including medication advice, rehabilitation exercise and one nurse-initiated follow-up call. Data were collected at baseline and after a 90-day (post-intervention) and a 180-day (post-intervention) follow-up. The primary outcome was quality of life (QOL), measured using the EuroQol-Five Dimension 5-Level scale (EQ-5D-5L). Results: both intervention and control groups showed improvement in EQ-5D-5L from baseline to post-intervention (0.66 versus 0.83, P < 0.001) and (0.66 versus 0.77, P < 0.001), respectively, and there was significant group-by-time interaction in EuroQol-Visual Analogue Scale from baseline to post-intervention at 90 days and follow-up at 180 days with the intervention group experiencing better improvement. Similarly, significant interaction effects were also found in the Stroke Impact Symptom scale, self-efficacy and modified Barthel Index. Conclusions: home-based transitional care was effective in improving QOL, symptoms, self-efficacy and activities of daily living.

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