Written by Peter Liu
Spoon Feed
The COMPASS program aids stroke patients with disabilities transitioning home by offering home modifications and strategy training to achieve functional goals and community participation, improving satisfaction immediately after discharge from rehab.
Synopsis
This randomized clinical trial evaluated the effectiveness of the COMPASS program, a rehabilitation transition intervention, compared to attentional control for stroke survivors transitioning from inpatient rehabilitation to home. While both groups showed similar improvements in community participation (Reintegration to Normal Living Index, P = .91), COMPASS participants demonstrated significantly greater advancements in self-rated performance (P = .046) and satisfaction (P = .02) with daily activities and a notable reduction in environmental barriers (P = .003 at 6 months). These findings suggest COMPASS effectively supports stroke survivors by mitigating home barriers and enhancing functional activity outcomes during the critical post-discharge phase.
Stroke recovery starts at home: Modify, strategize, and participate to thrive!
For patients with stroke, transitional planning on discharge home remains an area with much opportunity for improvement. The COMPASS program attempts to improve transitional planning by assessing home and community needs via a home visit with the patient and family prior to discharge, and modification of the home environment and provision of strategies for overcoming anticipated obstacles. The study compared the differences in patient satisfaction between questionnaires of COMPASS patients versus those who received less intensive transitional planning, showing some positive effects of the COMPASS interventions on patient satisfaction with activities of daily living (ADL) performance and removal of barriers to functional status at home. However, there are several limitations. First, roughly a quarter of patients were lost to follow-up, possibly related to impacts of COVID-19 restrictions during the implementation of the study. Second, despite the significantly increased resources provided to patients who had the COMPASS intervention, there was not a consistent improvement in all questionnaire results, including no significant difference in the primary outcome, community participation. Consequently, the results do not clearly support a large improvement in patient health and outcomes with COMPASS-like interventions. However, it remains best practice to help stroke patients modify their home environments and anticipate strategies for overcoming functional limitations prior to discharge home.
Source
Rehabilitation Transition Program to Improve Community Participation Among Stroke Survivors: A Randomized Clinical Trial. JAMA Netw Open. 2024 Oct 1;7(10):e2437758. doi: 10.1001/jamanetworkopen.2024.37758. PMID: 39374016
