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The Comprehensive Post-Acute Stroke Services (COMPASS) study: design and methods for a cluster-randomized pragmatic
Pamela W Duncan1, Cheryl D Bushnell1, Wayne D Rosamond2
1Department of Neurology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
BMC Neurology
|July 19, 2017
Summary
The COMprehensive Post-Acute Stroke Services (COMPASS) study evaluates a new care model to improve stroke recovery. This pragmatic trial assesses its effectiveness in enhancing patient outcomes and quality of life post-discharge.
Area of Science:
- Neurology
- Public Health
- Healthcare Management
Background:
- Stroke survivors face challenges with neurological deficits and chronic conditions post-discharge.
- Fragmented post-discharge care increases healthcare costs and readmissions.
- The COMprehensive Post-Acute Stroke Services (COMPASS) Study aims to address these issues.
Purpose of the Study:
- To assess the effectiveness of a comprehensive, evidence-based post-acute care model for stroke survivors.
- To improve patient-centered outcomes, including functional status and quality of life.
- To facilitate the rapid implementation of an effective care model into clinical practice.
Main Methods:
- A cluster-randomized pragmatic trial involving 41 hospitals in North Carolina.
- Intervention group received a comprehensive care model including telephone follow-up, clinic visits, and a care plan.
- Control group received usual care; outcomes assessed at 90 days via telephone surveys.
Main Results:
- Primary endpoint: patient-reported functional status using the Stroke Impact Scale 16.
- Secondary outcomes include caregiver strain, readmissions, mortality, healthcare utilization, and medication adherence.
- Stakeholder engagement is integral to the COMPASS care model's design and sustainability.
Conclusions:
- A comprehensive post-acute care model is critical for improving stroke survivor recovery and quality of life.
- The pragmatic trial design offers a real-world assessment of the COMPASS model's effectiveness.
- Successful outcomes could lead to widespread clinical adoption and improved stroke care.
