Korean Model for Post-acute Comprehensive rehabilitation (KOMPACT): The Study Protocol for a Pragmatic Multicenter Randomized Controlled Study on Early Supported Discharge

Won Kee Chang; Won-Seok Kim; Min Kyun Sohn; Sungju Jee; Yong-Il Shin; Sung-Hwa Ko; Minsu Ock; Hyun Joo Kim; Nam-Jong Paik

doi:10.3389/fneur.2021.710640

Korean Model for Post-acute Comprehensive rehabilitation (KOMPACT): The Study Protocol for a Pragmatic Multicenter Randomized Controlled Study on Early Supported Discharge

Front Neurol. 2021 Sep 8:12:710640. doi: 10.3389/fneur.2021.710640. eCollection 2021.

Authors

Won Kee Chang¹, Won-Seok Kim¹, Min Kyun Sohn², Sungju Jee², Yong-Il Shin³, Sung-Hwa Ko³, Minsu Ock⁴, Hyun Joo Kim⁵, Nam-Jong Paik¹

Affiliations

¹ Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
² Department of Rehabilitation Medicine, Chungnam National University College of Medicine, Chugnam National University Hospital, Daejeon, South Korea.
³ Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Pusan, South Korea.
⁴ Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
⁵ Department of Nursing Science, Shinsung University, Dangjin, South Korea.

Abstract

Introduction: Early supported discharge (ESD) is a transitional care model aimed at facilitating post-acute stroke patients' discharge to home. Previous studies have demonstrated that ESD provides equivalent patient and caregiver outcomes with superior cost-effectiveness compared to conventional rehabilitation (CR). This study intends to examine the feasibility of ESD in Korea. Methods and Analysis: This study is designed as a multicenter assessor-blinded, randomized controlled trial. Ninety post-acute stroke patients with mild to moderate disability (modified Rankin Scale 1-3) will be recruited from three university hospitals (30 patients per hospital) in Korea and allocated to either the ESD group or the CR group in a 1:1 ratio. Patients in the ESD group will receive individualized discharge planning and goal setting, a 4-week home-based rehabilitation program, and liaison service to community-based resources by a multidisciplinary team. Patients in the CR group will receive rehabilitation practices according to their current hospital policy. Outcomes: The primary outcome is the Korean version of the modified Barthel Index, and the primary endpoint was post-onset 3 months. Clinical outcomes, patient/caregiver reported outcomes, and socioeconomic outcomes will be measured at baseline, 1 month after discharge, 2 months after discharge, and 3 months after onset. Discussion: The efficacy and cost-effectiveness of ESD can vary according to the healthcare system and sociocultural aspects. To establish ESD as an alternative transitional care model for post-acute stroke patients in Korea, its feasibility needs to be examined in prior. This study will add evidence on the applicability of ESD in Korea. Ethical Considerations: The study protocol was reviewed and approved by the Institutional Review Board of Seoul National University Bundang Hospital (IRB number B-2012/654-308). The study protocol was registered at ClinicalTrials.gov (Identifier NCT04720820). Disseminations will include submission to peer-reviewed journals and presentations at conferences.

Keywords: Korea; early supported discharge; quality of life; randomized controlled trials; stroke; transitional care.

Associated data

ClinicalTrials.gov/NCT04720820