Telecare Consultation in Nurse-led Post-acute Stroke Clinic

NCT ID: NCT05081570

Last Updated: 2023-09-22

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 78 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-10-30
• Study Completion Date: 2023-07-30

Brief Summary

Introduction: The progress of stroke recovery is slow and enduring. If stroke survivors are not properly managed to facilitate their rehabilitation after discharged from hospital, their risk for recurrence after an index stroke will be very high. Globally, nurse-led post-acute stroke clinics have been developed to provide tertiary care services to support stroke survivors. While synthesized evidence supports the idea that the post-stroke services delivered by nurses in the clinic can improve the functional ability and reduce the readmission rate, shortcomings of these services such as compulsory traveling time and cost, long waiting time at the clinic, and the pandemic situation limit the clinic utilization by stroke survivors. Telecare consultation is a new modality aiming to provide a new healthcare access experience to the public, though how it can be applied in nurse-led clinic and what effects it can bring about on post-stroke survivors has not been reported.

Detailed Description

The aim of this pilot study is to determine the feasibility and effectiveness of telecare consultation in nurse-led post-acute stroke clinic.

Method: The present pilot study adopts a one-group pre-test post-test design. The potential subjects will be recruited from the clinic in Queen Elizabeth Hospital if they are (1) having a confirmed diagnosis of stroke within 1 month before enrolment, (2) referred to nurse-led post-acute stroke clinic, (3) aged 18 or above, (4) cognitively competent with a score ≥ 22 in the Montreal Cognitive Assessment Hong Kong version, (5) living at home before and after discharged from the acute stroke unit, and (6) having a smartphone or living with family member who has a smartphone. The participants will receive two tertiary stroke care consultations provided by stroke nurses via telecare in 2 months. The outcome measures include feasibility (reasons for refusal and drop-out, acceptance and satisfaction of both the advanced practising nurses and their patients towards the program), and effectiveness (degree of disability after stroke, activity of daily living, instrumental activity of daily living, health-related quality of life, depression). Data will be collected at pre- (T1) and post- (T2) intervention.

Discussion: The findings of this pilot study can provide a preliminary evidence on the use of telecare consultation in the nurse-led post-acute stroke clinic including its feasibility and effectiveness on both providers and patients. When gaps are identified, they could be adjusted to help develop and design a definitive, large-scale randomized controlled trial.

Conditions

Stroke

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

Intervention group

The participants will receive two tertiary stroke care consultations provided by stroke nurses via telecare in 2 months.

Group Type: EXPERIMENTAL

telecare consultation

Intervention Type: DEVICE

Two tertiary stroke care consultations will be provided by stroke nurses via telecare in 2 months. Consultation content includes provide education on modifying stroke-specific risk factors, disseminate self-management knowledge, reinforce the importance of medication compliance, revise the blood and investigation results, and co-design and follow-up on mutually agreed rehabilitation goals with the subjects. When necessary, the nurse will also refer the stroke survivors to multidisciplinary team members according to the referral guidelines. The nurse will also encourage the patients' family and/or informal caregivers to participate in the consultations.

Interventions

telecare consultation

Two tertiary stroke care consultations will be provided by stroke nurses via telecare in 2 months. Consultation content includes provide education on modifying stroke-specific risk factors, disseminate self-management knowledge, reinforce the importance of medication compliance, revise the blood and investigation results, and co-design and follow-up on mutually agreed rehabilitation goals with the subjects. When necessary, the nurse will also refer the stroke survivors to multidisciplinary team members according to the referral guidelines. The nurse will also encourage the patients' family and/or informal caregivers to participate in the consultations.

Intervention Type: DEVICE

Eligibility Criteria

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
• no Internet connection at home
• participating in other clinical trials at the same time
• require physical contact, i.e. wound dressing

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

Sponsors

The Queen Elizabeth Hospital

OTHER

Sponsor Role: collaborator

The Hong Kong Polytechnic University

OTHER

Sponsor Role: lead

Responsible Party

Arkers, Wong

Assistant professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Arkers Wong, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

The Hong Kong Polytechnic University

Locations

Queen Elizabeth Hospital

Kowloon, , Hong Kong

Countries

Hong Kong

Other Identifiers

P0035531

Identifier Type: -

Identifier Source: org_study_id