Effectiveness of a telehealth self-management program for people with mild stroke: results of a randomised controlled trial with longitudinal follow-up

Background And Aims: Mild Stroke: Enhancing and Guiding Transition Home (MiStrEnGTH) is an allied health led telehealth delivered self-management program for people with mild stroke during the first 6-months following discharge. The aim was to assess outcomes for quality of life (QoL), mood and confidence for people who received MiStrEnGTH compared to usual care. Methods: Randomised controlled trial with intention-to-treat analysis including people with mild stroke. Data collected at discharge, 1-month, 3-month, and 6-month follow-up using the Assessment of Quality of Life (AQOL), Depression Anxiety Stress Scales (DASS), and Confidence After Stroke Measure (CASM). Linear Mixed Model analyses explored within and between group differences including covariates. Results: Participants (n ¼ 39; 18 intervention: 21 control) with mean age of 64 years and 5.6 days average length of stay. There were: no significant between group differences for any outcome measures (p >.05) but a trend for different trajectories in favour of MiStrEnGTH; a significant improvement for AQOL and DASS for all participants (p ¼.020); and insignificant change for all with the CASM (p >.05). AQOL was significantly influenced by gender (p ¼.01), with better outcomes for men, and DASS was significantly and inversely influenced by age (p <.05). Conclusions: Changes in quality of life and mood suggest the need for support during this transition period, particularly for younger adults and women. Confidence as an outcome should be explored further. Although underpowered, the findings support the need for a larger trial to explore the different trajectories for AQOL, DASS and CASM which suggest a possible treatment effect.