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Nursing
Protocol
Effectiveness and cost-effectiveness of a virtual multidisciplinary stroke care clinic for community-dwelling stroke survivors and caregivers: a randomised controlled trial protocol
  1. Janita Pak Chun Chau1,
  2. Suzanne Hoi Shan Lo1,
  3. Vivian Wing Yan Lee2,
  4. Kai Chow Choi1,
  5. Edward Wai Ching Shum3,
  6. Zevari Sheung Sheung Hung4,
  7. Vincent Chung Tong Mok4,5,
  8. Elaine Kee Chen Siow1,
  9. Jessica Yuet Ling Ching4,5,
  10. Simon Kwun Yu Lam1,
  11. Jonas Hon Ming Yeung6,
  12. Siu Hung Li7,
  13. Alexander Yuk Lun Lau4,5
  1. 1 The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
  2. 2 School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
  3. 3 Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong
  4. 4 Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
  5. 5 Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
  6. 6 Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong
  7. 7 Department of Medicine, North District Hospital, Hong Kong
  1. Correspondence to Professor Suzanne Hoi Shan Lo; suzannelo{at}cuhk.edu.hk

Abstract

Introduction The virtual multidisciplinary stroke care clinic (VMSCC) is the first nurse-led clinic developed to offer support to community-dwelling stroke survivors and caregivers, and to promote poststroke recovery. This two-arm randomised controlled trial will evaluate its effectiveness on survivors’ self-efficacy (SE), survivors’ and caregivers’ health-related quality of life (HRQoL) and cost-effectiveness on emergency admissions and length of readmission hospital stay.

Methods and analysis A consecutive sample of 384 stroke survivor–caregiver dyads will be recruited from four hospitals. An online platform that embraces readily accessible and reliable information will be developed. Participants randomly assigned to the intervention group will receive usual care plus the VMSCC service. The service includes access to a tablet containing 30 videos demonstrating appropriate self-care strategies, communication with a registered nurse monthly through video and telephone calls and regular blood pressure monitoring. Primary outcomes include survivors’ SE in self-management and survivors’ and caregivers’ HRQoL. Secondary outcomes include survivors’ performance of self-management behaviours, depression and social participation; and caregivers’ coping strategies, satisfaction with caring and depression. Data will be collected at baseline, and at 3 and 6 months after commencing the intervention. Survivors’ and caregivers’ satisfaction with the service will be assessed at 6-month follow-up. Multivariable regressions and generalised estimating equations model will be conducted. Survivors’ emergency admissions and length of hospital stay will be evaluated during the 6-month follow-up period. Cost-effectiveness analysis will be performed on the average total cost incurred.

Discussion The results will inform stakeholders about incorporating the VMSCC service into current stroke rehabilitation service.

Ethics and dissemination This protocol was approved by the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (CREC Ref. No.: 2017.660). All participants will provide written informed consent. Results will be disseminated through scientific publications, and presentations at local and international conferences.

Trial registration number ChiCTR1800016101; Pre-results.

  • stroke
  • telerehabilitation
  • community health services
  • cost effectiveness
  • randomised controlled trial

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-026500

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    Footnotes

    • Contributors JPCC, SHSL, KCC and AYLL designed the study and wrote manuscript. VWYL, VCTM, EWCS, ZSSH, EKCS and JYLC are co-applicants of the grant submission. SKYL, JHMY and SHL are members of the study team who contributed to the conduct of the pilot study, and development of the study methods. All authors approved the final version of the manuscript

    • Funding This protocol was supported by the Health and Medical Research Fund (Grant Ref. No.: 15162991).

    • Competing interests None declared.

    • Ethics approval This protocol was approved by the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (CREC Ref. No.: 2017.660).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Not required.