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24-01-2022

Quality of life after stroke: a longitudinal analysis of a cluster randomized trial

Auteurs: Zhomart Orman, Amanda G. Thrift, Muideen T. Olaiya, David Ung, Dominique A. Cadilhac, Thanh Phan, Mark R. Nelson, Velandai K. Srikanth, Jason Vuong, Christopher F. Bladin, Richard P. Gerraty, Sharyn M. Fitzgerald, Judith Frayne, Joosup Kim, the STANDFIRM (Shared Team Approach between Nurses and Doctors For Improved Risk factor Management) Investigators

Gepubliceerd in: Quality of Life Research | Uitgave 8/2022

Abstract

Purpose

Health-related quality of life (QoL) is poor after stroke, but may be improved with comprehensive care plans. We aimed to determine the effects of an individualized management program on QoL in people with stroke or transient ischemic attack (TIA), describe changes in QoL over time, and identify variables associated with QoL.

Methods

This was a multicenter, cluster randomized controlled trial with blinded assessment of outcomes and intention‐to‐treat analysis. Patients with stroke or TIA aged ≥ 18 years were randomized by general practice to receive usual care or an intervention comprising a tailored chronic disease management plan and education. QoL was assessed at baseline and 3, 12, and 24 months after baseline using the Assessment of Quality of Life instrument. Patient responses were converted to utility scores ranging from − 0.04 (worse than death) to 1.00 (good health). Mixed-effects models were used for analyses.

Results

Among 563 participants recruited (mean age 68.4 years, 64.5% male), median utility scores ranged from 0.700 to 0.772 at different time points, with no difference observed between intervention and usual care groups. QoL improved significantly from baseline to 3 months (ß = 0.019; P = 0.015) and 12 months (ß = 0.033; P < 0.001), but not from baseline to 24 months (ß = 0.013; P = 0.140) in both groups combined. Older age, females, lower educational attainment, greater handicap, anxiety and depression were longitudinally associated with poor QoL.

Conclusion

An individualized management program did not improve QoL over 24 months. Those who are older, female, with lower educational attainment, greater anxiety, depression and handicap may require greater support.

Clinical trial registration

https://www.anzctr.org.au. Unique identifier: ACTRN12608000166370.

vorige artikel Quality of life profiles and their association with clinical and demographic characteristics and physical activity in people with a stoma: a latent profile analysis

volgende artikel Research engagement and experiences of patients pre- and post-implant of a left ventricular assist device from the mechanical circulatory support measures of adjustment and quality of life (MCS A-QOL) study

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Titel: Quality of life after stroke: a longitudinal analysis of a cluster randomized trial
Auteurs: Zhomart Orman
Amanda G. Thrift
Muideen T. Olaiya
David Ung
Dominique A. Cadilhac
Thanh Phan
Mark R. Nelson
Velandai K. Srikanth
Jason Vuong
Christopher F. Bladin
Richard P. Gerraty
Sharyn M. Fitzgerald
Judith Frayne
Joosup Kim
the STANDFIRM (Shared Team Approach between Nurses and Doctors For Improved Risk factor Management) Investigators
Publicatiedatum: 24-01-2022
Uitgeverij: Springer International Publishing
Gepubliceerd in: Quality of Life Research / Uitgave 8/2022
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-021-03066-y

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