Preventing depression in aphasia: A cluster randomized control trial of the Aphasia Action Success Knowledge (ASK) program.

Humans Stroke / complications Quality of Life Depression / prevention & control Single-Blind Method Aphasia / etiology
Aphasia cluster randomized controlled trial depression prevention psychosocial intervention stroke

Journal

International journal of stroke : official journal of the International Stroke Society
ISSN: 1747-4949
Titre abrégé: Int J Stroke
Pays: United States
ID NLM: 101274068

Informations de publication

Date de publication:
10 2023
Historique:
medline: 20 9 2023
pubmed: 8 5 2023
entrez: 8 5 2023
Statut: ppublish

Résumé

Stroke patients with aphasia and their caregivers have higher incidence of depression than those without aphasia. The objective of the study is to determine whether a tailored intervention program (Action Success Knowledge; ASK) led to better mood and quality of life (QoL) outcomes than an attention control with a 12-month end point at cluster and individual participant level. A multi-site, pragmatic, two-level single-blind cluster randomized controlled trial compared ASK to an attention control (secondary stroke prevention program). Ten metropolitan and 10 non-metropolitan health regions were randomized. People with aphasia and their family members were recruited within 6 months post-stroke who scored ⩽12 on the Stroke Aphasic Depression Questionnaire Hospital Version-10 at screening. Each arm received manualized intervention over 6-8 weeks followed by monthly telephone calls. Blinded assessments of QoL and depression were taken at 12 months post-onset. Twenty clusters (health regions) were randomized. Trained speech pathologists screened 1744 people with aphasia and 373 participants consented to intervention (n = 231 people with aphasia and 142 family members). The attrition rate after consent was 26% with 86 and 85 participants with aphasia in the ASK arm and attention control arm, respectively, receiving intervention. Of those 171 who did receive treatment, only 41 met the prescribed minimum dose. Multilevel mixed effects modeling under the intention-to-treat protocol showed a significant difference on the Stroke and Aphasia Depression Questionnaire-21 (SADQ-21, N = 122, 17 clusters) in favor of the attention control (β = -2.74, 95% confidence interval (CI) = -4.76 to -0.73, p = 0.008). Individual data analysis using a minimal detectable change score for the SADQ-21 showed the difference was not meaningful. ASK showed no benefit over attention control in improving mood and preventing depression in people with aphasia or their family members.

Sections du résumé

BACKGROUND
Stroke patients with aphasia and their caregivers have higher incidence of depression than those without aphasia.
AIMS
The objective of the study is to determine whether a tailored intervention program (Action Success Knowledge; ASK) led to better mood and quality of life (QoL) outcomes than an attention control with a 12-month end point at cluster and individual participant level.
METHODS
A multi-site, pragmatic, two-level single-blind cluster randomized controlled trial compared ASK to an attention control (secondary stroke prevention program). Ten metropolitan and 10 non-metropolitan health regions were randomized. People with aphasia and their family members were recruited within 6 months post-stroke who scored ⩽12 on the Stroke Aphasic Depression Questionnaire Hospital Version-10 at screening. Each arm received manualized intervention over 6-8 weeks followed by monthly telephone calls. Blinded assessments of QoL and depression were taken at 12 months post-onset.
RESULTS
Twenty clusters (health regions) were randomized. Trained speech pathologists screened 1744 people with aphasia and 373 participants consented to intervention (n = 231 people with aphasia and 142 family members). The attrition rate after consent was 26% with 86 and 85 participants with aphasia in the ASK arm and attention control arm, respectively, receiving intervention. Of those 171 who did receive treatment, only 41 met the prescribed minimum dose. Multilevel mixed effects modeling under the intention-to-treat protocol showed a significant difference on the Stroke and Aphasia Depression Questionnaire-21 (SADQ-21, N = 122, 17 clusters) in favor of the attention control (β = -2.74, 95% confidence interval (CI) = -4.76 to -0.73, p = 0.008). Individual data analysis using a minimal detectable change score for the SADQ-21 showed the difference was not meaningful.
CONCLUSION
ASK showed no benefit over attention control in improving mood and preventing depression in people with aphasia or their family members.

Identifiants

DOI: 10.1177/17474930231176718 PMID: 37154589 PMC: PMC10507993
pubmed: 37154589
doi: 10.1177/17474930231176718
pmc: PMC10507993
doi:

Banques de données

ANZCTR
['ACTRN12614000979651']

Types de publication

Randomized Controlled Trial Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

996-1004

Références

J Nurs Scholarsh. 2007;39(3):214-21
pubmed: 17760793
BMJ. 2014 Mar 07;348:g1687
pubmed: 24609605
Arch Phys Med Rehabil. 2017 Feb;98(2):235-240
pubmed: 27457540
Clin Rehabil. 2010 Feb;24(2):181-90
pubmed: 20103578
Trials. 2016 Mar 22;17:153
pubmed: 27005901
Stroke. 2001 Mar;32(3):696-701
pubmed: 11239189
Nurs Res. 2006 Sep-Oct;55(5):346-55
pubmed: 16980835
Clin Rehabil. 2012 Apr;26(4):372-81
pubmed: 22023890
BMJ Open. 2019 May 5;9(5):e023560
pubmed: 31061014
Rehabil Nurs. 2006 Jan-Feb;31(1):33-42
pubmed: 16422043
Int J Speech Lang Pathol. 2012 Apr;14(2):141-55
pubmed: 22149648
Disabil Rehabil. 2022 Oct;44(20):5811-5826
pubmed: 34383614
Clin Rehabil. 1998 Dec;12(6):506-13
pubmed: 9869254
Int J Stroke. 2013 Oct;8(7):566-74
pubmed: 23088304
Int J Evid Based Healthc. 2009 Mar;7(1):15-33
pubmed: 21631843
Clin Rehabil. 2013 May;27(5):398-408
pubmed: 23059701
J Neurol Neurosurg Psychiatry. 2005 Sep;76(9):1273-8
pubmed: 16107367
Cochrane Database Syst Rev. 2021 Nov 15;11:CD009286
pubmed: 34780067
Cochrane Database Syst Rev. 2021 Mar 5;3:CD011246
pubmed: 33667319
Disabil Rehabil. 2018 Aug;40(16):1870-1892
pubmed: 28420284
J Clin Epidemiol. 2018 Feb;94:85-96
pubmed: 29111470
BMJ. 2012 Sep 04;345:e5661
pubmed: 22951546
Int J Nurs Stud. 2012 Apr;49(4):386-97
pubmed: 22051438

Auteurs

Brooke Ryan (B)

Discipline of Clinical Psychology, University of Technology Sydney, Ultimo, NSW, Australia.
Centre of Research Excellence in Aphasia Rehabilitation Recovery, La Trobe University, Bundoora, Victoria, Australia.
Queensland Aphasia Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
Curtin School of Allied Health, Curtin University, Perth, WA, Australia.
ORCID: 0000-0002-6053-7614

Ian Kneebone (I)

Discipline of Clinical Psychology, University of Technology Sydney, Ultimo, NSW, Australia.
Centre of Research Excellence in Aphasia Rehabilitation Recovery, La Trobe University, Bundoora, Victoria, Australia.
ORCID: 0000-0003-3324-7264

Miranda L Rose (ML)

Centre of Research Excellence in Aphasia Rehabilitation Recovery, La Trobe University, Bundoora, Victoria, Australia.
School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia.
ORCID: 0000-0002-8892-0965

Leanne Togher (L)

Centre of Research Excellence in Aphasia Rehabilitation Recovery, La Trobe University, Bundoora, Victoria, Australia.
Department of Communication Sciences, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
ORCID: 0000-0002-4518-6748

Emma Power (E)

Centre of Research Excellence in Aphasia Rehabilitation Recovery, La Trobe University, Bundoora, Victoria, Australia.
Speech Pathology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia.

Tammy Hoffmann (T)

Institute for Evidence-Based Healthcare, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, QLD, Australia.

Asaduzzaman Khan (A)

Queensland Aphasia Research Centre, The University of Queensland, Brisbane, Queensland, Australia.

Nina Simmons-Mackie (N)

Southeastern Louisiana University, Hammond, LA, USA.

Marcella Carragher (M)

Centre of Research Excellence in Aphasia Rehabilitation Recovery, La Trobe University, Bundoora, Victoria, Australia.
School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia.

Linda Worrall (L)

Centre of Research Excellence in Aphasia Rehabilitation Recovery, La Trobe University, Bundoora, Victoria, Australia.
Queensland Aphasia Research Centre, The University of Queensland, Brisbane, Queensland, Australia.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Preventing depression in aphasia: A cluster...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Preventing depression in aphasia: A cluster...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Mesures épidémiologiques › Démographie › État de santé › Qualité de vie › Preventing depression in aphasia: A cluster...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Émotions › Dépression › Preventing depression in aphasia: A cluster...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Méthodologie en recherche épidémiologique › Méthode en simple aveugle › Preventing depression in aphasia: A cluster...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Troubles du langage › Troubles de la parole › Aphasie › Preventing depression in aphasia: A cluster...