Pragmatic multicenter randomized controlled study on early supported discharge after stroke in Korea: the KOMPACT...

Area of Science:

• Neurology
• Rehabilitation Medicine
• Health Services Research

Background:

• Early supported discharge (ESD) is beneficial in Western stroke care but its effectiveness in Asian healthcare systems is not well-established.
• This study evaluates ESD in the Korean context for post-acute stroke recovery.

Purpose of the Study:

• To compare the efficacy and economic impact of ESD versus conventional rehabilitation (CR) in Korean acute stroke patients.
• To assess functional outcomes, mood, costs, and patient satisfaction.

Main Methods:

• The Korean Model for post-acute comprehensive rehabilitation (KOMPACT) study was a multicenter, randomized controlled trial.
• Patients with mild-to-moderate stroke (mRS 1-3) were assigned to ESD (home-based rehab, liaison services) or CR.
• Outcomes were assessed at baseline, 1 month, and 3 months post-stroke.

Main Results:

• No significant differences in clinical outcomes or functional dependence between ESD and CR groups.
• The ESD group showed significantly greater improvement in depressive symptoms (p=0.025).
• Patient and caregiver satisfaction were higher in the ESD group; length of stay and total costs were comparable.

Conclusions:

• ESD is a feasible transitional care model for Korean stroke patients, offering comparable clinical and economic outcomes to CR.
• ESD demonstrated potential benefits in mood improvement and higher patient satisfaction.
• Further research with larger samples and longer follow-up is recommended to confirm long-term effects.