Early supported discharge after XXXX in Bergen (ESD Stroke Bergen): three and six months results of a randomised controlled trial comparing two early supported discharge schemes with treatment as usual.

@entity1 @entity64
UNASSIGNED: BackgroundStroke causes lasting disability and the burden of @entity64 is expected to increase substantially during the next decades. Optimal rehabilitation is therefore mandatory. Early supported discharge (ESD) has previously shown beneficial, but all major studies were carried out more than ten years ago. We wanted to implement and study the results of ESD in our community today with comparisons between ESD and treatment as usual, as well as between two different ESD models.MethodsPatients with acute @entity64 were included during a three year period (2008  11) in a randomised controlled study comparing two different ESD models to treatment as usual. The two ESD models differed by the location of treatment: either in a day unit or in the @entity1   homes. @entity1 in the ESD groups were followed by a multi-disciplinary ambulatory team in the @entity64 unit and discharged home as early as possible. The ESD models also comprised treatment by a multi-disciplinary community health team for up to five weeks and follow-up controls after 3 and 6 months. Primary outcome was modified Rankin Scale (mRS) at six months.ResultsThree-hundred-and-six @entity1 were included. mRS scores and change scores were non-significantly better in the two ESD groups at 3 and 6  months. Within-group improvement from baseline to 3  months was significant in the ESD 1 (p  =  0.042) and ESD 2 (p  =  0.001) groups, but not in the controls. More @entity1 in the pooled ESD groups were independent at 3 (p  =  0.086) and 6  months (p  =  0.122) compared to controls and there also was a significant difference in 3  month change score between them (p  =  0.049). There were no differences between the two ESD groups. Length of stay in the @entity64 unit was 11  days in all groups.ConclusionsPatients in the ESD groups tended to be more independent than controls at 3 and 6 months, but no clear statistically significant differences were found. The added effect of supported discharge and improved follow-up seems to be rather modest. The improved @entity64 treatment of today may necessitate larger @entity1 samples to demonstrate additional benefit of ESD.Clinical trial registrationUnique identifier: NCT00771771.
