Abstract NS13: YOU CALL - WE CALL Trial: Impact of a Multimodal Support Intervention After a “Mild” Stroke
purpose: To assess the impact of a post-discharge multimodal support intervention - “WE CALL” versus a passive “YOU CALL” intervention (providing telephone contact information of a resource person) in individuals with first mild stroke. Primary outcomes were unplanned use of health services for negative events and quality of life. Secondary outcomes included planned use of health services, participation and mood.
Methods: Single-blind RCT stratified on level of co-morbidity. WE CALL participants were phoned 13 times over the six month period (weekly to monthly) by a trained healthcare professional to discuss any new or ongoing issues. Blind assessments were done at baseline and at 6 and 12 months. Use of health services was collected through participant diaries. We used a mixed model approach for statistical analysis on an intention-to-treat basis where the group factor was intervention type and occasion factor time, with a significance level of 0.01.
Results: We enrolled 186 patients (We = 92; You = 94) with a mean age 62.5 ± 12.5 and 41% female. There were no baseline differences between groups on the primary (Euroquol-EQ5D, Quality of Life Index) or secondary outcomes (Assessment of Life-Habits (LIFE-H), and Beck Depression Inventory II). At six months, 92% (137/149) had visited a physician while less than 20% a rehabilitation specialist. No significant differences were seen between groups at six months on any outcomes with both groups improving from baseline on all measures (effect sizes ranged from 0.2 to 0.8). The only significant change from 6 months to one year (n=139) was in the social domains (relationships, work and recreation) of the LIFE-H (increment in score=0.4/9±1.3 [95%CI=0.1-0.7]; ES=0.3). Qualitatively the WE Call intervention was perceived as reassuring, increased insight and problem solving while decreasing anxiety. In contrast, only 6/94 (6.4%) of YOU Call participant availed themselves of intervention.
Conclusion: While the two groups improved equally over time, some of the WE CALL intervention key features, which will be described, were reported to be very helpful.
Clinical Trial Registration: http://www.controlled-trials.com unique identifier: ISRCTN95662526
Funding: Canadian Stroke Network/CIHR
- © 2012 by American Heart Association, Inc.