Stroke Homecare and Recurrence Prevention

NCT ID: NCT06810024

Last Updated: 2025-02-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

1614 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-27

Study Completion Date

2026-04-26

Brief Summary

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Background and Significance:

Stroke is the leading cause of death in China, placing a heavy burden on patients, families, and society. Despite advancements in acute stroke treatment, the recurrence rate remains high, and secondary prevention faces significant challenges. Current standard care does not fully address the diverse needs of stroke patients. Home-based health care (HBHC) offers a promising new intervention, providing continuous medical support, personalized lifestyle changes, and improved medication adherence, potentially reducing the risk of stroke recurrence.

Study Objectives and Hypotheses:

The study seeks to assess the impact of HBHC on reducing stroke recurrence, improving quality of life, enhancing physical function, addressing psychological health issues, and increasing medication adherence. Additionally, the study will explore the cost-effectiveness of HBHC in reducing medical resource utilization and preventing cardiovascular events. It is hypothesized that HBHC will effectively reduce stroke recurrence and improve overall health outcomes.

Study Design This study is a multicenter, randomized controlled trial designed to assess the effectiveness and cost-effectiveness of a home-based health care (HBHC) model in preventing recurrent strokes. A total of 1,614 stroke patients will be recruited from multiple regions in China and randomly assigned in a 1:1 ratio to either the intervention group or the control group. The intervention group will receive a comprehensive 12-month HBHC program that includes managing stroke recurrence risk factors, functional rehabilitation, daily living skills recovery, psychological health interventions, nutritional and lifestyle counseling, risk prevention, and caregiver empowerment. In contrast, the control group will receive standard post-stroke care and follow-up according to local guidelines. Both groups will undergo follow-up assessments at 6 and 12 months to evaluate stroke recurrence, quality of life, physical function, and psychological health. The study will span 2 years, with the primary outcome being the stroke recurrence rate within 12 months. Secondary outcomes include improvements in quality of life, physical function recovery, psychological health, medication adherence, cardiovascular events, and medical resource utilization. A process evaluation will also be conducted to assess the feasibility, adaptability, and implementation challenges of the HBHC model across different regions and patient populations.

Value and impact:

The findings will offer valuable insights into the feasibility and adaptability of HBHC across different regions and patient populations, contributing to the development of evidence-based strategies for improving long-term stroke management. Ultimately, this research will inform policy decisions, enhance clinical practice, and support the broader adoption of HBHC interventions to mitigate the burden of stroke and improve patient outcomes.

Detailed Description

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Conditions

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Stroke

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Intervetnion group (Home-Based care group)

Participants in this arm will receive a comprehensive home-based health care program designed to prevent stroke recurrence and enhance recovery. The intervention includes monitoring and management of stroke recurrence risk factors (e.g., blood pressure, blood sugar, cholesterol), functional rehabilitation, psychological health support, nutritional and lifestyle interventions, complication prevention, and caregiver empowerment. These interventions will be delivered over a 12-month period, and participants will be followed up at 6 and 12 months.

Group Type EXPERIMENTAL

Home-based therapy

Intervention Type COMBINATION_PRODUCT

The home-based intervention includes the following modules:

1. Management of Stroke Recurrence Risk Factors: Home-based monitoring and management of blood pressure, blood sugar, cholesterol, and medication adherence.
2. Functional Rehabilitation and Daily Living Skills: Home-based physical therapy, rehabilitation exercises, and recovery of daily living skills.
3. Psychological Health and Emotional Management: Home-based counseling and mental health support to address anxiety, depression, and stress.
4. Nutritional and Lifestyle Interventions: At-home guidance on healthy eating, lifestyle changes, and behavior modification to reduce stroke recurrence.
5. Risk and Complication Prevention: Home monitoring to prevent infections and other complications during recovery.
6. Caregiver Empowerment: Home-based caregiver training and support to improve caregiving skills and reduce caregiver stress.

Control group (standard care group)

Participants in this arm will receive standard post-stroke care according to local clinical guidelines. This care may include outpatient visits for monitoring and medication management, inpatient rehabilitation services (e.g., physical, occupational, speech therapy), follow-up appointments with healthcare providers, and community-based rehabilitation services. Participants will be followed up at 6 and 12 months to assess stroke recurrence and recovery outcomes.

Group Type ACTIVE_COMPARATOR

Standard Care (in control arm)

Intervention Type OTHER

The standard care intervention involves:

Outpatient Visits: Routine follow-up visits to healthcare providers for stroke recovery monitoring, medication management, and adjustments.

Inpatient Rehabilitation: Physical, occupational, and speech therapy delivered in hospital or rehabilitation centers, if required.

Follow-up Appointments: Regular visits with stroke specialists and rehabilitation professionals for ongoing care.

Interventions

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Home-based therapy

The home-based intervention includes the following modules:

1. Management of Stroke Recurrence Risk Factors: Home-based monitoring and management of blood pressure, blood sugar, cholesterol, and medication adherence.
2. Functional Rehabilitation and Daily Living Skills: Home-based physical therapy, rehabilitation exercises, and recovery of daily living skills.
3. Psychological Health and Emotional Management: Home-based counseling and mental health support to address anxiety, depression, and stress.
4. Nutritional and Lifestyle Interventions: At-home guidance on healthy eating, lifestyle changes, and behavior modification to reduce stroke recurrence.
5. Risk and Complication Prevention: Home monitoring to prevent infections and other complications during recovery.
6. Caregiver Empowerment: Home-based caregiver training and support to improve caregiving skills and reduce caregiver stress.

Intervention Type COMBINATION_PRODUCT

Standard Care (in control arm)

The standard care intervention involves:

Outpatient Visits: Routine follow-up visits to healthcare providers for stroke recovery monitoring, medication management, and adjustments.

Inpatient Rehabilitation: Physical, occupational, and speech therapy delivered in hospital or rehabilitation centers, if required.

Follow-up Appointments: Regular visits with stroke specialists and rehabilitation professionals for ongoing care.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adults aged 18 years and older
* Diagnosed with ischemic or hemorrhagic stroke within the past month
* Clinically stable, having completed acute phase treatment, and about to be discharged in a normal condition
* Physically able to receive home-based health care services
* Residing in a community where home-based health care is available
* Able to provide informed consent or have a legally authorized representative provide consent

Exclusion Criteria

* Receiving more than one month of post-discharge care at a stroke rehabilitation center or community rehabilitation center
* Severe comorbidities (e.g., cancer, respiratory failure, severe infections) with a life expectancy of less than 6 months
* Severe cognitive impairment or mental illness affecting adherence to the intervention
* Currently participating in another clinical trial
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Peking Union Medical College

OTHER

Sponsor Role lead

Responsible Party

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Xuejun Yin

Prof

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Xuejun Yin, PhD

Role: CONTACT

18600988138

Xuejun Yin, PhD

Role: CONTACT

+86 18600988138

Other Identifiers

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2021-RC330-004

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

CAMS&PUMC-IEC-2025-008

Identifier Type: -

Identifier Source: org_study_id

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