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Effect of occupational therapy home visit discharge planning on participation after stroke: protocol for the HOME Rehab trial
Open accessAbstract
Introduction: After first stroke, the transition from rehabilitation to home can be confronting and fraught with challenges. Although stroke clinical practice guidelines recommend predischarge occupational therapy home visits to ensure safe discharge and provision of appropriate equipment, there is currently limited evidence to support this recommendation. Methods and analysis: The HOME Rehab trial is a national, multicentre, phase III randomised controlled trial with concealed allocation, blinded assessment and intention-to-treat analysis being conducted in Australia. The trial aim is to determine the effect and potential cost-effectiveness of an enhanced occupational therapy discharge planning intervention that involves pre and postdischarge home visits, goal setting and occupational therapy in the home (the HOME programme) in comparison to an in-hospital predischarge planning intervention. Stroke survivors aged ≥45 years, admitted to a rehabilitation ward, expected to return to a community (private) dwelling after discharge, with no significant prestroke disability will be randomly allocated 1:1 to receive a standardised discharge planning intervention and the HOME programme or the standardised discharge planning intervention alone. The primary outcome is participation measured using the Nottingham Extended Activities of Daily Living. Secondary outcome areas include hospital readmission, disability, performance of instrumental activities of daily living, health-related quality of life, quality of care transition and carer burden. Resources used/costs will be collected for the cost-effectiveness analysis and hospital readmission. Recruitment commenced in 2019. Allowing for potential attrition, 360 participants will be recruited to detect a clinically important treatment difference with 80% power at a two-tailed significance level of 0.05. Ethics and dissemination: This study is approved by the Alfred Health Human Research Ethics Committee and site-specific ethics approval has been obtained at all participating sites. Results of the main trial and the secondary endpoint of cost-effectiveness will be submitted for publication in peer-reviewed journals Trial registration number NCT12618001360202
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Studies with an evaluation protocol as extensive and complete as the one used in this research are not common.
“Studies with an evaluation protocol as extensive and complete are not common [47].”
From Early Occupational Therapy Intervention post-stroke (EOTIPS): A randomized controlled trial (2024) · cites this paper as [47]
The Process evaluation section describes a detailed plan covering fidelity, implementation and RE-AIM measures, and the Discussion says the trial includes process and economic evaluations. The Discussion calls it the first trial of this particular intervention, but the paper does not say that studies with similarly extensive evaluation protocols are generally uncommon. The indexed passages provide no page numbers. (LLM, conf=0.82)
Experimental — accuracy not yet measuredInclusion and exclusion criteria used were those usually described in previous research but with an improved evaluation protocol that included valid and reliable clinical tools.
“In the current study, inclusion and exclusion criteria used were those usually described in previous researches but with an improved evaluation protocol that included valid and reliable clinical tools [47].”
From Early Occupational Therapy Intervention post-stroke (EOTIPS): A randomized controlled trial (2024) · cites this paper as [47]
The HOME Rehab protocol lists its inclusion and exclusion criteria in “Participants, therapists, sites” (page unavailable) and names clinical outcome measures in “Secondary outcomes,” including a measure it explicitly calls validated (page unavailable). It does not establish that the citing authors used criteria customary in previous research, or that their evaluation protocol was improved and used valid and reliable tools. (LLM, conf=0.82)
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Early Occupational Therapy Intervention post-stroke (EOTIPS): A randomized controlled trial
García-Pérez, P., Rodríguez-Martínez, M. C., Gallardo-Tur, A., Blanco-Reina, E., de la Cruz-Cosme, C., & Lara, J. P. (2024) · PLoS ONE · doi:10.1371/journal.pone.0308800 · Cited by 19
“Studies with an evaluation protocol as extensive and complete are not common [47].”
Metadata
- Authors
- Lannin, N. A., Clemson, L., Drummond, A., Stanley, M., Churilov, L., Laver, K., O'Keefe, S., Cameron, I., Crotty, M., Usherwood, T., Andrew, N. E., Jolliffe, L., & Cadilhac, D. A.
- Affiliations
- Alfred Health (AU)
- The University of Sydney (AU)
- University of Nottingham (GB)
- Edith Cowan University (AU)
- The Royal Melbourne Hospital (AU)
- Flinders University (AU)
- Monash Health (AU)
- Florey Institute of Neuroscience and Mental Health (AU)
- Corresponding author
- Lannin, Natasha A
- ORCID
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2021-07
- Volume
- 11
- Issue
- 7
- Pages
- e044573
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC8258558
- OpenAlex
- W3182112793
- Cited by
- 11
- References
- 3
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 3 · 2023: 2
- FWCI
- 0.66
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (acceptedVersion, cc-by-nc)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by-nc)
- Australasian Journal of Paramedicine (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by-nc)
- La Trobe University
- Funders
- National Health and Medical Research Council (GNT1063761, GNT1141561)
- National Heart Foundation of Australia (GNT102055)
- Australian Research Council (DE200101494)
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Health Professions › Occupational Therapy › Occupational Therapy Practice and Research
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- stroke, occupational therapy, home visits, discharge planning, hospital-to-home transition, participation, activities of daily living, instrumental activities of daily living, hospital readmission, caregiver burden, health-related quality of life, cost-effectiveness
- MeSH terms
- Stroke Rehabilitation, Activities of Daily Living, Aftercare, Australia, House Calls, Humans, Middle Aged, Occupational Therapy, Patient Discharge, Quality of Life, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Stroke
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