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Exploring post acute rehabilitation service use and outcomes for working age stroke survivors (≤65 years) in Australia, UK and South East Asia: Data from the international AVERT trial

Walters, Rosy, Collier, Janice M, Braighi Carvalho, Lillian, Langhorne, Peter, Katijjahbe, Md Ali, Tan, Dawn, Moodie, Marj, Bernhardt, Julie and AVERT Trialists' Collaboration 2020, Exploring post acute rehabilitation service use and outcomes for working age stroke survivors (≤65 years) in Australia, UK and South East Asia: Data from the international AVERT trial, BMJ Open, vol. 10, no. 6, pp. 1-10, doi: 10.1136/bmjopen-2019-035850.

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Title Exploring post acute rehabilitation service use and outcomes for working age stroke survivors (≤65 years) in Australia, UK and South East Asia: Data from the international AVERT trial
Author(s) Walters, Rosy
Collier, Janice M
Braighi Carvalho, Lillian
Langhorne, Peter
Katijjahbe, Md Ali
Tan, Dawn
Moodie, MarjORCID iD for Moodie, Marj orcid.org/0000-0001-6890-5250
Bernhardt, Julie
AVERT Trialists' Collaboration
Journal name BMJ Open
Volume number 10
Issue number 6
Article ID e035850
Start page 1
End page 10
Total pages 10
Publisher BMJ Publishing Group
Place of publication London, Eng.
Publication date 2020-06
ISSN 2044-6055
2044-6055
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
young stroke
rehabilitation services
return to work
outcome
international
QUALITY-OF-LIFE
RETURN-TO-WORK
YOUNG-ADULTS
ISCHEMIC-STROKE
SCALE
NEEDS
HAD
AVERT Trialists’ Collaboration
Summary Objectives Information about younger people of working age (≤65 years), their post stroke outcomes and rehabilitation pathways can highlight areas for further research and service change. This paper describes: (1) baseline demographics; (2) post acute rehabilitation pathways; and (3) 12-month outcomes; disability, mobility, depression, quality of life, informal care and return to work of working age people across three geographic regions (Australasia (AUS), South East (SE) Asia and UK).Design This post hoc descriptive exploration of data from the large international very early rehabilitation trial (A Very Early Rehabilitation Trial (AVERT)) examined the four common post acute rehabilitation pathways (inpatient rehabilitation, home with community rehabilitation, inpatient rehabilitation then community rehabilitation and home with no rehabilitation) experienced by participants in the 3 months post stroke and describes their 12-month outcomes.Setting Hospital stroke units in AUS, UK and SE Asia.Participants Patients who had an acute stroke recruited within 24 hours who were ≤65 years.Results 668 participants were ≤65 years; 99% lived independently, and 88% no disability (modified Rankin Score (mRS)=0) prior to stroke. We had complete data for 12-month outcomes for n=631 (94%). The proportion receiving inpatient rehabilitation was higher in AUS than other regions (AUS 52%; UK 25%; SE Asia 23%), whereas the UK had higher community rehabilitation (UK 65%; AUS 61%; SE Asia 39%). At 12 months, 70% had no or little disability (mRS 0–2), 44% were depressed, 28% rated quality of life as poor or worse than death. For those working prior to stroke (n=228), only 57% had returned to work. A noteworthy number of working age survivors received no rehabilitation services within 3 months post stroke.Conclusions There was considerable variation in rehabilitation pathways and post acute service use across the three regions. At 12 months, there were high rates of depression, poor quality of life and low rates of return to work.
Language eng
DOI 10.1136/bmjopen-2019-035850
Indigenous content off
Field of Research 1103 Clinical Sciences
1117 Public Health and Health Services
1199 Other Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30139270

Document type: Journal Article
Collections: Faculty of Health
Population Health
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.