Rehabilitation of stroke: A summary of the ATTEND study(Family-led Rehabilitation after Stroke in India))

This would seem to contradict all the early supported discharge out there. Mainly being taken for cost savings in the hospital.  6 posts on early supported discharge here.
http://www.cmijournal.org/article.asp?issn=0973-4651;year=2017;volume=15;issue=4;spage=285;epage=287;aulast=Valson


Anna T Valson
Christian Medical College, Vellore, India

Date of Web Publication

17-Nov-2017

Correspondence Address:
Source of Support: None, Conflict of Interest: None

DOI: 10.4103/cmi.cmi_70_17

How to cite this article: Valson AT. Rehabilitation of stroke: A summary of the ATTEND study. Curr Med Issues 2017;15:285-7

How to cite this URL: Valson AT. Rehabilitation of stroke: A summary of the ATTEND study. Curr Med Issues [serial online] 2017 [cited 2017 Nov 21];15:285-7. Available from: http://www.cmijournal.org/text.asp?2017/15/4/285/218641

Source: This is a summary of the study: The ATTEND collaborative Group: Family-led rehabilitation after stroke in India (ATTEND): a randomized controlled trial. Lancet. 2017 Aug 5;390. (10094):588-599. Summary prepared by Dr. Anna T. Valson, Christian Medical College, Vellore, India.

Clinical Question: Is family-led rehabilitation superior to usual care for stroke patients in a low-resource setting?

Authors' conclusions: (1) Family-led rehabilitation did not improve outcomes, but did not cause harm such as adding to caregiver burden. (2) The results of the study do not currently support the setting up of stroke rehabilitation services that shift tasks to family caregivers.

Why this Study?

Stroke patients in developing countries such as India have limited the access to a multidisciplinary team of health professionals who can monitor and facilitate their rehabilitation after hospital discharge and provide much needed support to caregivers. Since the development of such multidisciplinary teams across the length and breadth of the country is not economically or logistically feasible, an attractive low-cost alternative is “Task Shifting,”^[1] i.e., training caregivers to provide the needed physiotherapy to patients at home. The importance of this approach has been highlighted by the WHO in its Task Shifting Guidelines.^[2] Although this is an approach that makes eminent practical sense and is scalable, there is very little evidence that it is effective in improving disease outcomes. This study ^[3] aimed to generate evidence regarding whether Task Shifting to family caregivers could reduce death and disability in stroke patients in India. A pilot study was carried out at Christian Medical College, Ludhiana, Punjab, to establish the trial methods,^[4] and the protocol was published before data analysis of this study.^[5]