Abstract
Objectives: To define whether an individualized management program affects health-related quality of life (QoL) in patients with stroke or transient ischemic attack (TIA), and to determine factors associated with better QoL.
Methods: Patients aged at least 18 years with stroke or TIA were recruited from four urban hospitals in Victoria (Australia) for a multicentre, cluster-randomized controlled trial with blinded assessment of outcomes and an intention-to-treat analysis. Participants in the control group received usual care. Those in the intervention group were provided with a nurse-led stroke-specific education and an individualized chronic disease management plan with input from a stroke physician on top of usual care. We used the Assessment of Quality of Life instrument to measure QoL and an established algorithm to convert responses to utility scores, ranging from -0.04 (worse than death) to 0.00 (equal to death) to 1.00 (good health). The Mann-Whitney U test was applied to compare QoL between the two study groups. Quantile regression models were used to identify factors associated with QoL at 3, 12 and 24 months.
Results: Overall, we recruited 563 participants with a mean age of 68 years, and 36% being female. At 24 months after baseline, the response rate was 89%. No difference was detected between the intervention and usual care groups at any time point. Factors independently and consistently (at all time points) associated with poorer QoL included older age and presence of handicap and anxiety. Females, single marital status, lower educational attainment, living in an institution, and depression were independently associated with poorer QoL at specific, but not all, time points.
Conclusions: The intervention did not affect QoL over two years after stroke. Managing handicap, anxiety and depression could improve the QoL of patients with stroke or TIA.
Methods: Patients aged at least 18 years with stroke or TIA were recruited from four urban hospitals in Victoria (Australia) for a multicentre, cluster-randomized controlled trial with blinded assessment of outcomes and an intention-to-treat analysis. Participants in the control group received usual care. Those in the intervention group were provided with a nurse-led stroke-specific education and an individualized chronic disease management plan with input from a stroke physician on top of usual care. We used the Assessment of Quality of Life instrument to measure QoL and an established algorithm to convert responses to utility scores, ranging from -0.04 (worse than death) to 0.00 (equal to death) to 1.00 (good health). The Mann-Whitney U test was applied to compare QoL between the two study groups. Quantile regression models were used to identify factors associated with QoL at 3, 12 and 24 months.
Results: Overall, we recruited 563 participants with a mean age of 68 years, and 36% being female. At 24 months after baseline, the response rate was 89%. No difference was detected between the intervention and usual care groups at any time point. Factors independently and consistently (at all time points) associated with poorer QoL included older age and presence of handicap and anxiety. Females, single marital status, lower educational attainment, living in an institution, and depression were independently associated with poorer QoL at specific, but not all, time points.
Conclusions: The intervention did not affect QoL over two years after stroke. Managing handicap, anxiety and depression could improve the QoL of patients with stroke or TIA.
| Original language | English |
|---|---|
| Pages | 81-81 |
| Number of pages | 1 |
| DOIs | |
| Publication status | Published - 2021 |