Can stroke specific vocational rehabilitation (SSVR) be delivered and measured?: feasibility RCT and economic analysis

Radford, Kathryn A. and Grant, Mary and Sinclair, Emma and Terry, Jane and Sampson, Christopher James and Edwards, Claire and Walker, Marion F. and Lincoln, Nadina and Drummond, Avril E.R. and Phillips, Julie and Watkins, Louise and Rowley, Emma and Brain, Nicola and Guo, Boliang and Jarvis, M. and Jenkinson, M. (2014) Can stroke specific vocational rehabilitation (SSVR) be delivered and measured?: feasibility RCT and economic analysis. Clinical Rehabilitation, 28 (4). pp. 403-415. ISSN 1477-0873

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Abstract

Background:

A quarter of UK strokes occur in working age people. Fewer than half resume work. Rehabilitation frequently fails to address work needs and evidence for post-stroke vocational rehabilitation is lacking. This pilot trial tested the feasibility of delivering SSVR and measuring its effects and costs compared to usual care (UC).

Method:

Previously employed stroke survivors (SS) aged ≥16 recruited from a stroke unit were randomised to receive SSVR or UC. Exclusion criteria: refusing consent; not intending to work, medical preclusion. Primary outcomes: occupational and benefit status. Mood, function, participation, quality of life and resource use were measured using standardized and bespoke postal questionnaires at 3, 6 and 12 months. Service use was cross-referenced in 10% of participants and costs calculated.

Results:

46/126 patients screened (36 men, mean 56 (SD 12.7, 18-78 years) were recruited in 15 months; 40 declined. Most (29) had NIHSS scores ≤ 15, were in professional roles (65%), self-employed (21.7%) at onset. 32 available at 12-month follow-up, with poorer response (61%) among UC. Intervention successfully deployed in 22/23 cases. 39% returned to work at 12 months - twice as many in SSVR. More depression and productivity loss in UC, especially at 6 mths. Cross-referencing for 5 participants involved 51 phone calls, 23 letters/emails. Self-reported and actual service use data were discrepant. SS underestimated GP& consultant and overestimated therapy input.

Discussion:

SSVR can be delivered and its effects and costs measured. More reliable methods of capturing service use, income and benefit data and clearer definitions of work are needed.

Conclusion:

Findings inform the definitive trial.

Item Type: Article
Additional Information: Proceedings of the SRR Summer 2013 meeting
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Rehabilitation and Ageing
Identification Number: 10.1177/0269215513506172
Depositing User: Dziunka, Patricia
Date Deposited: 17 Jan 2017 10:28
Last Modified: 12 Oct 2017 22:05
URI: http://eprints.nottingham.ac.uk/id/eprint/39880

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