Virtual stroke care program shows improved patient experience and self-management in older adults
Transitional Care Stroke Intervention (TCSI) results in enhanced functioning and self-care
A multisite pragmatic randomized controlled trial conducted through the Aging, Community and Health Research Unit (ACHRU) aimed to test the effectiveness of a program called Transitional Care Stroke Intervention (TCSI) in older adults with stroke and multiple chronic conditions. Researchers, including School of Nursing faculty members Professor Emerita Maureen Markle-Reid, Associate Professor Rebecca Ganann, Assistant Professor Carly Whitmore, Assistant Professor and Research Associate Kathryn Fisher, and others, compared usual care to the TCSI.
The TCSI was designed to improve both the quality and experience of hospital-to-home transitions by enhancing patients’ self-management. It is a multicomponent intervention, co-designed with healthcare providers and older adults with lived experience of stroke. The intervention was delivered by interprofessional teams of health care providers from two hospital-based outpatient stroke rehabilitation clinics. The TCSI included a post-discharge phone call follow-up within two days of hospital discharge, up to six virtual visits by phone or videoconference, monthly team conferences, and ongoing care coordination/system navigation support for patients, supported by the My Stroke Recovery Journey website.
The trial was run in two locations in Ontario, Hamilton and St. Catharines, and enrolled 90 participants who were randomized to an intervention group and a control group. After 11 participants were lost to follow-up, 79 participants remained and fully completed the study. The intervention group showed greater improvements in overall physical functioning, stroke self-management, and patient experience compared to the control group. Between the two groups, there were no differences in hospital readmissions and these improvements were achieved at no added costs to the system.
The researchers noted that the shift from in-person to virtual care due to the COVID-19 pandemic might have influenced the results. They suggested the need for a larger study in different geographical locations and more diverse groups to better understand the intervention’s impact and its scalability.
In conclusion, the TCSI was shown to improve physical function, stroke self-management, and patient experience without increasing overall healthcare costs in older adults with stroke and multiple chronic conditions. The study’s limitations include the impact of the pandemic and a need for further research to confirm these findings in different populations and geographic locations. Read the full study here.
Research