Early supported discharge after stroke

Peter Langhorne*, Lotta Widen-Holmqvist, Gillian Taylor (Member of Consortium), Gordon Murray (Member of Consortium), Torunn Askim (Member of Consortium), Martin Dennis (Member of Consortium), Craig Anderson (Member of Consortium), Erik Bautz-Holter (Member of Consortium), Paola Dey (Member of Consortium), Bent Indredavik (Member of Consortium), Nancy Mayo (Member of Consortium), Michael Power (Member of Consortium), Helen Rodgers (Member of Consortium), Ole Morten Ronning (Member of Consortium), Anthony Rudd (Member of Consortium), Nijasri Suwanwela (Member of Consortium), Charles Wolfe (Member of Consortium)

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Patients after stroke conventionally receive much of their rehabilitation in hospital. Services have been developed that offer patients an early discharge from hospital with more rehabilitation at home (early supported discharge). This paper sets out a systematic review of all randomized trials of early supported discharge services that included 12 trials (1659 patients). There was a reduced odds of death or dependency equivalent to 5 fewer adverse outcomes (95% confidence interval 1-10) for every 100 patients receiving an early supported discharge service (p = 0.04). Patients receiving early supported discharge services showed an 8 day reduction (p < 0.0001) in the length of hospital stay. The greatest benefits were seen in the trials evaluating a co-ordinated multidisciplinary early supported discharge team and with patients with mild-moderate disability. The experience of a trial from Stockholm is described in order to explore the potential mechanism of action of early supported discharge services. In conclusion, an illustrative case report is set out, indicating a typical patient pathway in an early supported discharge service.

Original languageEnglish
Pages (from-to)103-108
Number of pages6
JournalJournal of Rehabilitation Medicine
Volume39
Issue number2
DOIs
Publication statusPublished - Mar 2007

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