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Journal Article

Citation

Hackett ML, Carter G, Crimmins D, Clarke T, Maddock K, Sturm JW. Int. J. Stroke 2010; 5(1): 52-56.

Copyright

(Copyright © 2010, John Wiley and Sons)

DOI

10.1111/j.1747-4949.2009.00388.x

PMID

20088995

Abstract

RATIONALE: One in three patients experience depression after stroke and this risk is consistent over time. A strategy to prevent depression that could be economically delivered to most stroke patients and ideally which also has a low likelihood of adverse events needs to be developed and evaluated. Aims POST aims to determine whether a simple intervention (postcards) prevents depression (Hospital Anxiety and Depression rating Scale, HADS depression subscale score > or =8) in patients with a recent stroke. Secondary end-points include reduced anxiety (HADS anxiety subscale score > or =8) and improved health-related quality of life in patients with a recent stroke.
DESIGN: A single-centre randomised, double-blind, pilot trial to prevent depression in patients with a recent (within 8 weeks) stroke presenting to hospital. Patients will be enrolled over 12 months and randomised to receive three trial-specific assessments (baseline, 3- and 6-month assessments of mood, HRQoL and social functioning), or three trial-specific assessments plus a postcard sent centrally in a sealed envelope at 1, 2, 3, 4 and 5 months after discharge from hospital. Blinded follow-up telephone assessments will be conducted for both groups. STUDY OUTCOMES AND SAMPLE SIZE: For the primary end-point the POST trial will have 80% power to detect a relative risk of 0.4 given an incidence of depression of 30%. For the secondary aims POST has 90% power to detect a difference of 3 points on the HADS depression subscale (assuming a standard deviation of 6 points) between randomised groups. This includes an inflation factor of 15% to account for patients lost to follow-up.
DISCUSSION: Evidence of efficacy will determine whether a multi-centre, international trial is warranted.


Language: en

Keywords

Humans; Research Design; Social Environment; Anxiety; Pilot Projects; Cost-Benefit Analysis; Suicide, Attempted; Health Services Accessibility; Quality of Life; Social Behavior; Clinical Protocols; Activities of Daily Living; Depressive Disorder; Stroke

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