| Title: |
Effectiveness of early vocational rehabilitation versus usual care to support RETurn to work After stroKE: a pragmatic, parallel arm multi-centre, randomised-controlled trial |
| Authors: |
Radford, K.A.; Wright-Hughes, A.; Thompson, E.; Clarke, D.J.; Phillips, J.; Holmes, J.; Powers, K.; Trusson, D; Craven, K; Watkins, C.; Bowen, Audrey; McKevitt, Chris; Stevens, J.; Murray, J.; O'Connor, R.J.; Pyne, S.; Risebro, H.; Cameron, R.; Sach, T.H.; Day, F.; Farrin, A.J. |
| Publication Year: |
2024 |
| Collection: |
University of Southampton: e-Prints Soton |
| Description: |
Background: return-to-work is a major goal achieved by fewer than 50% stroke survivors. Evidence onhow to support return-to-work is lacking. Aims: to evaluate the clinical effectiveness of Early Stroke Specialist Vocational Rehabilitation (ESSVR) plus usual care (UC) (i.e. usual NHS rehabilitation) versus UC alone for helping people return-to-work after stroke. Methods: this pragmatic, multicentre, individually randomised controlled trial with embedded economic and process evaluations, compared ESSVR with UC in 21 NHS stroke services across England and Wales. Eligible participants were aged ≥18 years, in work at stroke onset, hospitalised with new stroke and within 12-weeks of stroke. People not intending to return-to-work were excluded. Participants were randomised (5:4) to individually-tailored ESSVR delivered by stroke-specialist occupational-therapists for up to 12-months or usual National Health Service rehabilitation. Primary outcome was self-reported return-to-work for ≥2 hours per week at 12-months. Primary and safety analyses were done in the intention-to-treat population. Results: between 1st June-2018, and 7th March-2022, 583 participants (mean age 54.1 years [SD 11.0], 69% male) were randomised to ESSVR (n=324) or UC (n=259). Primary outcome data were available for 454(77.9%) participants. Intention-to-treat analysis showed no evidence of a difference in the proportion of participants returned-to-work at 12-months (165/257[64.2%] ESSVR vs 117/197[59.4%] UC; adjusted odds ratio 1.12 [95%CI 0.8 to 1.87],p=0.3582). There was some indication that older participants and those with more post-stroke impairment were more likely to benefit from ESSVR (interaction p=0.0239 and p=0.0959 respectively). Conclusions: to our knowledge, this is the largest trial of a stroke VR intervention ever conducted. We found no evidence that ESSVR conferred any benefits over UC in improving return-to-work rates 12-months post-stroke. Return-to-work (for at least 2 hours per week) rates were higher than in previous studies ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://eprints.soton.ac.uk/497084/1/radford-et-al-2024-effectiveness-of-early-vocational-rehabilitation-versus-usual-care-to-support-return-to-work-after.pdf; https://eprints.soton.ac.uk/497084/2/IJS-07-24-12528.R2_Proof_hi.pdf; https://eprints.soton.ac.uk/497084/3/Acceptance.pdf; Radford, K.A., Wright-Hughes, A., Thompson, E., Clarke, D.J., Phillips, J., Holmes, J., Powers, K., Trusson, D, Craven, K, Watkins, C., Bowen, Audrey, McKevitt, Chris, Stevens, J., Murray, J., O'Connor, R.J., Pyne, S., Risebro, H., Cameron, R., Sach, T.H., Day, F. and Farrin, A.J. , RETAKE Research group (2024) Effectiveness of early vocational rehabilitation versus usual care to support RETurn to work After stroKE: a pragmatic, parallel arm multi-centre, randomised-controlled trial. International Journal of Stroke. (doi:10.1177/17474930241306693 ). |
| Availability: |
https://eprints.soton.ac.uk/497084/; https://eprints.soton.ac.uk/497084/3/Acceptance.pdf |
| Rights: |
cc_by_4 |
| Accession Number: |
edsbas.FDDC385 |
| Database: |
BASE |