Stroke Canada Optimization of Rehabilitation by Evidence Implementation Trial SCORE-IT)

NCT ID: NCT00359593

Last Updated: 2008-03-20

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: PHASE2/PHASE3
• Total Enrollment: 2000 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2006-09-30
• Study Completion Date: 2008-04-30

Brief Summary

The aim of this project is to evaluate whether using an implementation intervention promotes use of best practices by rehabilitation professionals and leads to improvements in patient outcomes for individuals with stroke.

Detailed Description

Stroke is a leading cause of disability in Canada and frequently causes hemiparesis (upper limb and lower limb weakness on one side of the body). Approximately one third of stroke survivors require physical rehabilitation to improve their motor and functional recovery (1). Although many strategies have been shown to be effective in promoting recovery after stroke, the uptake of evidence-based practice by rehabilitation professionals across Canada is variable. The aim of this project is to evaluate whether using an implementation intervention promotes use of best practices by rehabilitation professionals and leads to improvements in patient outcomes for individuals with stroke.

This project is a cluster randomized implementation trial for upper and lower limb interventions. Rehabilitation centres across Canada will be randomized to receive either an outcome-oriented implementation strategy (OOI) to facilitate implementation of the EIPRs or a process-oriented implementation strategy (POI). At the onset, rehabilitation professionals practicing in all centres will receive education in using best practice outcome measures related to stroke rehabilitation. All centres will be assessed for baseline adherence to the EIPRs. Centres in the OOI will receive "usual care" (i.e. passive dissemination of the written protocols and information about outcome measures). Centres in the POI arm will receive a combination of strategies to facilitate EIPR uptake (i.e., use of a local facilitator, practice audits with feedback, reminder systems and educational sessions). Following exposure to the EIPRs, all centres will document adherence to the EIPRs, and patient outcomes as assessed by the measures. An analysis of the costs associated with rehabilitation interventions and the incremental expense of a POI strategy will be undertaken. These data will be used to compare the OOI and POI centres with respect to the level of uptake and implementation of EIPRs and related expenses.

Conditions

Stroke

Keywords

Stroke; Rehabilitation; Knowledge translation; Evidence based practice; Outcomes

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Blinding Strategy: SINGLE

Interventions

Knowledge translation intervention package

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• hospital with designated rehabilitation beds;
• regularly treats stroke patients;
• has access to at least one physical (PT) and one occupational (OT) therapist on the health professional team

• medically stable;
• stroke with residual disability;
• requires complex rehabilitation interventions from at least 3 health care professionals, one of them being an OT or a PT;
• admitted to rehabilitation centre within 90 days of stroke onset;
• and age >18 years

Exclusion Criteria

• Inadequate staffing to administer the outcome measures consistently

Patients:

• having a medical condition that is expected to result in death within 6 months;
• presence of a serious chronic disabling condition that impacts on either the rehabilitation process or rehabilitation outcomes such as severe arthritis, dementia, Parkinson's disease;
• active suicidal ideation or symptoms of psychosis

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

McGill University

OTHER

Sponsor Role: collaborator

Toronto Rehabilitation Institute

OTHER

Sponsor Role: lead

Principal Investigators

Mark T Bayley, MD

Role: PRINCIPAL_INVESTIGATOR

Toronto Rehabilitation Institute

Sharon Wood-Dauphinee, PhD

Role: PRINCIPAL_INVESTIGATOR

McGill University

Locations

Toronto Rehabilitation Institute

Toronto, Ontario, Canada

Site Status: RECRUITING

McGill University

Montreal, Quebec, Canada

Site Status: NOT_YET_RECRUITING

Countries

Canada

Central Contacts

Amanda G Hurdowar, MSc

Role: CONTACT

Phone: 416-597-3422

Email: Hurdowar.Amanda@TorontoRehab.on.ca

Facility Contacts

Amanda Hurdowar, MSc

Role: primary

Sharon Wood-Dauphinee, PhD

Role: primary

References

Salbach NM, Wood-Dauphinee S, Desrosiers J, Eng JJ, Graham ID, Jaglal SB, Korner-Bitensky N, MacKay-Lyons M, Mayo NE, Richards CL, Teasell RW, Zwarenstein M, Bayley MT; Stroke Canada Optimization of Rehabilitation By Evidence - Implementation Trial (SCORE-IT) Team. Facilitated interprofessional implementation of a physical rehabilitation guideline for stroke in inpatient settings: process evaluation of a cluster randomized trial. Implement Sci. 2017 Aug 1;12(1):100. doi: 10.1186/s13012-017-0631-7.

Reference Type: DERIVED

PMID: 28764752 (View on PubMed)

Related Links

http://www.canadianstrokenetwork.ca/eng/index_flash.php

Canadian Stroke Network

Other Identifiers

CSNscore

Identifier Type: -

Identifier Source: org_study_id