Article

Randomised controlled trials have shown the benefits of Early
Supported Discharge (ESD) of stroke survivors. Our aim was to evaluate whether
ESD is still beneficial when operating in the complex context of frontline
healthcare provision. DESIGN: We conducted a cohort study with quasi experimental
design. A total of 293 stroke survivors (transfer independently or with
assistance of one, identified rehabilitation goals) within two naturally formed
groups were recruited from two acute stroke units:
'ESD' n=135 and 'Non ESD'
n=158 and 84 caregivers.
The 'ESD' group accessed either of two ESD services
operating in Nottinghamshire, UK. The 'Non ESD' group experienced standard
practices for discharge and onward referral. Outcome measures (primary: Barthel
Index) were administered at baseline, 6 weeks, 6 months and 12 months. RESULTS:
The ESD group had a significantly shorter length of hospital stay (P=0.029) and
reported significantly higher levels of satisfaction with services received
(P<0.001). Following adjustment for age differences at baseline, participants in
the ESD group (n=71) had significantly higher odds (compared to the Non ESD
group, n=85) of being in the 90 Barthel Index category at 6 weeks (OR = 1.557,
95% CI 2.579 to 8.733), 6 months (OR = 1.541, 95% CI 2.617 to 8.340) and 12
months (OR 0.837, 95% CI 1.306 to 4.087) respectively in relation to baseline.
Carers of patients accessing ESD services showed significant improvement in
mental health scores (P<0.01). CONCLUSION: The health benefits of ESD are still
evident when evidence based models of these services are implemented in practice.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS