Joubert 2009.
| Study characteristics | ||
| Methods | RCT Unit of randomisation: participant |
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| Participants | Place of recruitment: hospital Numbers randomised: total: 233 (I: 123; C: 110) % Completing final follow‐up: 80% Inclusion criteria: ischaemic stroke, parenchymal haemorrhage or TIA; aged ≥ 20 years Exclusion criteria: not managed by GP; discharged to nursing home; serious co‐morbidities; non‐English speaking; serious cognitive impairment; significantly aphasic Type of stroke (%): ischaemic (I: 73%; C: 80%); haemorrhagic (I: 10%: C: 7%); TIA (I: 17%; C: 13%) Mean age (SD): I: 63.4 (13.7); C: 68.2 (12.7) Gender (% men): I: 58%; C: 52% Ethnicity: not reported Socio‐economic or socio‐demographic status: not reported |
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| Interventions | Intervention details (components, length, frequency): "shared care" program; risk factor targets derived from National guidelines and consensus statements; medication initiated in hospital; lifestyle education provided by nurse coordinator; GP appointments pre‐arranged for 2 weeks, 3 months, 6 months, 9 months and 12 months post‐discharge; recommendations and evidence‐based guidelines sent to GP; nurse co‐ordinator telephoned participants before and after every GP visit to screen for depression; risk factor data collected at each GP visit and faxed to nurse co‐ordinator; nurse co‐ordinator facilitated transfer of information and recommendations between stroke specialists and GPs; GPs able to telephone stroke specialist for advice Location: community Mode of delivery: telephone follow‐up; information management Personnel responsible for delivery: stroke specialists, a nurse co‐ordinator and participants' GPs Timing post‐stroke: intervention initiated before hospital discharge Control: standard care from GP |
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| Outcomes | 12 months: SBP; DBP, total cholesterol, BMI, systolic BP < 140 mmHg; total cholesterol < 5.18 mmol/L; proportion of AF patients taking warfarin | |
| General Information | Funding: this research was funded by a Commonwealth of Australia General Practice Evaluation Program grant Country of origin: Australia Publication language: English |
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| Notes | Analysis method: not stated Risk of bias: unclear |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | "Computer‐generated process" "At a later stage, the coordinator checked the patient’s GP, and if this GP was also responsible for a different patient already in the trial, the current patient was assigned to the same group as the previous patient" |
| Allocation concealment (selection bias) | Low risk | "The allocation to group was undertaken after consent, so the coordinator was unaware of treatment allocation prior to consent" |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Missing data reported by group Attrition: I: 32/123 (7 unwilling to participate; 2 withdrew due to other medical problems, 2 changed GP; 11 withdrew for unknown reasons; 3 did not have stroke; 3 not contactable; 2 died; 1 moved to nursing home; 1 GP refused); C: 15/110 (2 unwilling to participate; 1 left country; 3 withdrew for unknown reasons; 2 did not have stroke; 1 not contactable; 6 died) Judgement: imbalances in missing data between the groups; however the review authors judged that this was unlikely to be related to study outcomes |
| Selective reporting (reporting bias) | Unclear risk | Insufficient information (protocol not obtained) |
| Other bias | Low risk | The study appears to be free of other sources of bias |