A community-based intervention to prevent serious complications and death 2 years after discharge in people with spinal cord injury in Bangladesh (CIVIC): a randomised trial

Autor: Stephen Jan, Fin Biering-Sørensen, Qiang Li, Robert D. Herbert, Stephen Muldoon, Richard I. Lindley, Shofiqul Islam, Valerie H. Taylor, Akhlasur Rahman, Laurent Billot, Hueiming Liu, Lisa A. Harvey, Ian D. Cameron, Mohammad Sohrab Hossain
Rok vydání: 2020
Předmět:
Zdroj: Spinal Cord
Hossain, M S, Harvey, L A, Islam, M S, Rahman, M A, Muldoon, S, Biering-Sorensen, F, Jan, S, Liu, H, Li, Q, Cameron, I D, Taylor, V, Lindley, R I, Billot, L & Herbert, R D 2021, ' A community-based intervention to prevent serious complications and death 2 years after discharge in people with spinal cord injury in Bangladesh (CIVIC) : a randomised trial ', Spinal Cord, vol. 59, pp. 649–658 . https://doi.org/10.1038/s41393-020-00546-9
ISSN: 1476-5624
Popis: Study design Randomised controlled trial. Objectives To determine the effectiveness of a sustainable community-based intervention designed to prevent serious complications and death 2 years after discharge in people with spinal cord injury in Bangladesh. Setting Bangladesh. Methods A pragmatic randomised controlled trial was undertaken. People who had sustained a spinal cord injury in the preceding 2 years, were wheelchair-dependent, and were about to be discharged from hospital in Bangladesh were recruited and randomised to an Intervention or Control group using a concealed allocation procedure stratified by level of lesion (tetraplegia/paraplegia). Participants in the Intervention group received 36 phone calls and three home visits over the first 2 years following discharge. All participants received usual post-discharge care. Survival status and date of death were determined by blinded assessors 2 years after randomisation. Results Between July 2015 and March 2018, 410 participants were randomised (204 to Intervention, 206 to Control). There was no loss to follow up. At 2 years, 15 (7.4%) participants in the Intervention group and 16 (7.8%) participants in the Control group had died (hazard ratio from unadjusted Cox model = 0.93 [95% CI, 0.46 to 1.89]; p from log rank test 0.85). There were no clinically important or statistically significant average causal effects of intervention on the incidence or severity of complications. Conclusion A program of community-based care for people with recent spinal cord injury in Bangladesh involving frequent phone contact and occasional in-person contact with a health professional after discharge from hospital is no better at preventing death at 2 years than usual care.
Databáze: OpenAIRE
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