Evidence map›Paper›PMID 37872479›Full record

Trial reportBMC geriatrics2023

The stroke transitional care intervention for older adults with stroke and multimorbidity: a multisite pragmatic randomized controlled trial.

Maureen Markle-Reid, Kathryn Fisher, Kimberly M Walker, Marla Beauchamp, Jill I Cameron, David Dayler, Rebecca Fleck, Amiram Gafni, Rebecca Ganann, Ken Hajas and 6 more

Registry-linked trialOpen access · goldAbstract readMulticenter StudyPragmatic Clinical TrialRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC geriatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04278794 (Optimizing Hospital-to-home Transitions for Older Adults With Stroke and Multimorbidity), which is not on this map. Cited by 25 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 5 pooled it
6.1field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04278794 nacompletednot on this map

Optimizing Hospital-to-home Transitions for Older Adults With Stroke and Multimorbidity: A Pragmatic Trial of an Outpatient-based Virtual Transitional Care Intervention

TypeinterventionalSponsorMcMaster UniversityRan2020 to 2022Enrolled90ConditionsStrokeArmsTransitional Care Stroke Intervention (TCSI)
3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 5 syntheses or guidelines pooled it, 44 citations in OpenAlex.

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  6. Smart Healthcare-Enabled Information-Motivation-Behavioral Skills Model for Stroke Multimorbidity Rehabilitation: A Transitional Care Study.Medical science monitor : international medical journal of experimental and clinical research · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 6 institutions in 2 countries.

Maureen Markle-ReidSchool of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, ON, L8S 4K1, Canada. mreid@mcmaster.ca.ORCID http://orcid.org/0000-0002-4019-7077
Kathryn FisherSchool of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, ON, L8S 4K1, Canada.ORCID http://orcid.org/0000-0001-8342-1238
Kimberly M WalkerAging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, ON, L8S 4K1, Canada.
Marla BeauchampMcMaster Institute for Research On Aging, McMaster University, Hamilton, ON, Canada.
Jill I CameronDepartment of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, 160-500 University Ave, Toronto, ON, M5V 1V7, Canada.ORCID http://orcid.org/0000-0003-4161-1572
David DaylerAging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, ON, L8S 4K1, Canada.
Rebecca FleckRehabilitation Program, Parkwood Institute, St. Joseph's Health Care London, 268 Grosvenor Street, Ontario, N6A 4V2, London, Canada.
Amiram GafniHealth Research Methods, Department of Health, Evidence and Impact, Faculty of Health Sciences, and the Centre of Health Economics and Policy Analysis, McMaster University, 1280 Main Street West, HSC 2C, Hamilton, ON, L8S 4K1, Canada.ORCID http://orcid.org/0000-0001-8279-8172
Rebecca GanannSchool of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, ON, L8S 4K1, Canada.ORCID http://orcid.org/0000-0002-7566-8932
Ken HajasAging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, ON, L8S 4K1, Canada.
Barbara KoetsierAging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, ON, L8S 4K1, Canada.
Robert MahonyAging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, ON, L8S 4K1, Canada.
Chris PollardHotel Dieu Shaver Health, and Rehabilitation Centre, 541 Glenridge Ave, St. Catherines, ON, L2T 4C2, Canada.
Jim PrescottAging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, ON, L8S 4K1, Canada.
Tammy RookeCarePartners, 139 Washburn Drive, Kitchener, ON, N2R 1S1, Canada.ORCID http://orcid.org/0000-0002-5348-5975
Carly WhitmoreSchool of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, ON, L8S 4K1, Canada.ORCID http://orcid.org/0000-0002-3974-4854
McMaster University · CAHotel Dieu Shaver Health and Rehabilitation Centre · CAImpact · CAParkwood Institute · CASt Michael’s Hospital · GBUniversity of Toronto · CA

Funding

CIHR PJT 166026
6 · The paper itself

Abstract

backgroundThis study aimed to test, in real-world clinical practice, the effectiveness of a Transitional Care Stroke Intervention (TCSI) compared to usual care on health outcomes, self-management, patient experience, and health and social service use costs in older adults (≥ 55 years) with stroke and multimorbidity (≥ 2 chronic conditions).

methodsThis pragmatic randomized controlled trial (RCT) included older adults discharged from hospital to community with stroke and multimorbidity using outpatient stroke rehabilitation services in two communities in Ontario, Canada. Participants were randomized 1:1 to usual care (control group) or usual care plus the 6-month TCSI (intervention group). The TCSI was delivered virtually by an interprofessional (IP) team, and included care coordination/system navigation support, phone/video visits, monthly IP team conferences, and an online resource to support system navigation. The primary outcome was risk of hospital readmission (all cause) after six-months. Secondary outcomes included physical and mental functioning, stroke self-management, patient experience, and health and social service use costs. The intention-to-treat principle was used to conduct the primary and secondary analyses.

resultsNinety participants were enrolled (44 intervention, 46 control); 11 (12%) participants were lost to follow-up, leaving 79 (39 intervention, 40 control). No significant between-group differences were seen for baseline to six-month risk of hospital readmission. Differences favouring the intervention group were seen in the following secondary outcomes: physical functioning (SF-12 PCS mean difference: 5.10; 95% CI: 1.58-8.62, p = 0.005), stroke self-management (Southampton Stroke Self-Management Questionnaire mean difference: 6.00; 95% CI: 0.51-11.50, p = 0.03), and patient experience (Person-Centred Coordinated Care Experiences Questionnaire mean difference: 2.64, 95% CI: 0.81, 4.47, p = 0.005). No between-group differences were found in total healthcare costs or other secondary outcomes.

conclusionsAlthough participation in the TCSI did not impact hospital readmissions, there were improvements in physical functioning, stroke self-management and patient experience in older adults with stroke and multimorbidity without increasing total healthcare costs. Challenges associated with the COVID-19 pandemic, including the shift from in-person to virtual delivery, and re-deployment of interventionists could have influenced the results. A larger pragmatic RCT is needed to determine intervention effectiveness in diverse geographic settings and ethno-cultural populations and examine intervention scalability.

trial registrationClinicalTrials.gov Identifier: NCT04278794 . Registered May 2, 2020.

Indexed as

StrokeTransitional CareAgedHumansMultimorbidityOntarioQuality of LifeCommunity-based careCostsEffectivenessHealthcare interventionMultimorbidityOlder adultsStroke rehabilitationTransitions

Identifiers

PMID37872479
PMCPMC10594728
OpenAlexW4387893063

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.