Community Participation Transition After Stroke (COMPASS) Randomized Controlled Trial: Effect on Adverse Health Events.
Melissa J Krauss, Brianna M Holden, Emily Somerville and 7 others
PMID 38772517WHAT IT FOUND
Stroke survivors who received home modifications and self-management training from an OT had fewer deaths and nursing home admissions.
Falls and 30-day readmissions were not significantly reduced. This safety benefit was a secondary finding, not the trial's primary aim.
Key findings
01The intervention group had zero deaths compared to ten deaths in the control group, a significant reduction in hazard.
02Nursing home admissions were significantly lower in the intervention group, with a reduced hazard compared to controls.
03Fall rates and 30-day rehospitalizations were numerically lower in the intervention group but did not reach statistical significance.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
These safety outcomes were not the primary aim of the trial, which was designed to test participation and activity performance. The study excluded people with significant cognitive impairment or moderate-to-severe aphasia, so results may not apply to those groups. Falls were tracked via self-report and monthly calls, which may miss some events, and the study did not determine the specific cause of falls. The intervention was complex, combining home modifications with self-management training, so it is unclear which component drove the outcomes.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that this intervention prevents falls or readmissions. While the numbers were lower, the study found no significant difference for these outcomes. The significant benefits were for survival and avoiding nursing home admission, which were secondary safety measures, not the trial's primary targets.