Welin 2010.
| Study characteristics | ||
| Methods | RCT Unit of randomisation: participant |
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| Participants | Place of recruitment: rural hospital Numbers randomised: total: 163 (I: 81; C: 82) % Completing final follow‐up: 71% Inclusion criteria: ischaemic or haemorrhagic stroke; first stroke; < 85 years; living at home before the stroke Exclusion criteria: previous stroke; severe dementia; severe stroke (Rankin score > 5); severe cardiovascular disease; life expectancy < 1 year Type of stroke (%): haemorrhagic I:9%, C:16% Mean age (SD): I: 71.2 (9.9); C: 69.6 (11.7) Gender (% women): I: 41%; C: 37% Ethnicity: not reported Socio‐economic or socio‐demographic status: not reported |
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| Interventions | Intervention: follow‐up appointments with a stroke nurse at 1.5, 6 and 12 months post‐discharge (included assessment of handicap and depression, measurement of blood pressure, provision of health information and referral to physiotherapist or occupational therapist if necessary); appointments with a stroke physician at 3 and 9 months (included a review of medication and medical problems with referral to other specialists if necessary) Location: hospital stroke clinic Mode of delivery: outpatient appointment Personnel responsible for delivery: stroke nurse and stroke physician Timing post‐stroke: 1.5 to 12 months post‐discharge Control: usual care involved follow‐up with GP; GPs were sent discharge summaries; "the quality of follow‐up care by general practitioners varies in Sweden from non follow‐up at all to regular visits every third or fourth month" Usual care before discharge (I and C): initiation of secondary prevention medications and referral to continuous physiotherapy or occupation therapy, if necessary |
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| Outcomes | SBP (12 months); DBP (12 months); recurrent stroke (3.5 years) | |
| General Information | Funding: this study was supported by grants from the Research Fund at Skaraborg Hospital, the Skaraborg Institute for Research and Development, and the Swedish Stroke Association Country of origin: Sweden Publication language: English |
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| Notes | Analysis method: not stated Risk of bias: low |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Shuffling sealed envelopes |
| Allocation concealment (selection bias) | Low risk | Shuffling sealed envelopes |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Missing data reported by group Attrition: I: 18/81 (5 died, 13 did not attend follow‐up visit); C: 30/82 (9 died, 21 did not attend follow‐up visit) Judgement: reasons for missing data reported and review authors judge that they are unlikely to be related to study outcomes |
| Selective reporting (reporting bias) | Low risk | Study protocol available and outcomes are reported in the pre‐specified way |
| Other bias | Low risk | The study appears to be free from other sources of bias |
AF: atrial fibrillation AMT: Abbreviated Mental Test APN: advanced practice nurse BMI: body mass index BP: blood pressure C: control DBP: diastolic blood pressure GP: general practitioner HDL: high density lipoprotein I: intervention IQR: interquartile range LDL: low density lipoprotein NIHSS: National Institutes of Stroke Scale RCT: randomised controlled trial SBP: systolic blood pressure SD: standard deviation SE: standard error TIA: transient ischaemic attack