System of Care Trial
The LoTS care Stroke System of Care Trial is a cluster randomised controlled trial of a patient and carer-centred system of longer-term stroke care.
Aims
This study aims to evaluate the clinical and cost effectiveness of our new system for longer-term stroke care which has been developed by a comprehensive review of the evidence and forms a patient centred structured assessment.
Stroke care co-ordinators have been trained to deliver the system of care. The trial aims to recruit 800 patients (with and without carers) in 32 stroke care co-ordinator led services around the UK.
Objectives
The LoTS care trial aims to evaluate whether our new system of care improves psychological and functional outcomes of patients and carers living at home in the community when compared to usual practice.
Primary Objective: To determine whether the system of care improves psychological outcomes for patients requiring longer-term support at home
Secondary Objectives:
- To determine whether the provision of the system of care improves functional outcomes for patients requiring longer-term support at home
- To determine whether the provision of the system of care improves psychological and functional outcomes for carers of patients requiring longer-term support at home
- To assess whether the system of care is cost-effective based on patient outcomes from both health/social care and societal perspectives.
A concurrent realist evaluation on the trial is being led by Natasha Alvarado as part of a fellowship award from the Stroke Association.
Recent Status
Phase 1 of patient recruitment started in July 2009 and phase 2 of patient recruitment started in February 2010. Intervention services have received two training days and are implementing the system of care into their practice. Control services are carrying on as normal.
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Recruitment of the target 800 patients
was achieved on 31st March 2011
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401 patients were recruited to the intervention arm and 399 to the control arm. 26% of patients also have carers who have been recruited to the trial.
6 month follow up of participants is complete and 12 month followup is now ongoing.
