Family support for stroke: one year follow up of a randomised controlled trial

Background: There is evidence that family support can benefit carers of stroke patients, but not the patients themselves. Objective: To extend the follow up of a single blind randomised controlled trial of family support for stroke patients and carers to one year to ascertain whether there were any late effects of the intervention. Methods: The study was a randomised controlled trial. Patients admitted to hospital with acute stroke who had a close carer were assigned to receive family support or normal care. Families were visited at home by a researcher 12 months after the stroke, and a series of questionnaires was administered to patient and carer. Results: The benefits to carers mostly persisted, though they were no longer statistically significant because some patients were lost to follow up. There was no evidence of any effects on patients. Conclusion: Family support is effective for carers, but different approaches need to be considered to alleviate the psychosocial problems of stroke patients. Abbreviations: FSO, family support organiser; SF-36, short form 36 item health assessment questionnaire Keywords: caregiver; family support; stroke In recognition of the impact that stroke has on carers as well as patients,1 services such as Stroke Association family support have been developed in the United Kingdom which provide information, emotional support, and liaison with other services. The service maintains contact through a combination of home and hospital visits and telephone calls. In the Oxford family support trial, we found that this service was associated with significantly improved quality of life of carers at follow up six months after the stroke, but had no effects on patients.2 Other randomised controlled trials of the service in other areas have also found no evidence of benefit to patients with follow up varying from four to nine months after recruitment.3,4 The lack of benefit to patients may be attributable to the short duration of follow up in these trials. The service usually maintains contact with a family for a year, and some patients spend a significant proportion of the first six months in hospital, during which time family support might be anticipated to have less impact. We carried out a second follow up of participants in the Oxford trial to investigate the effects of family support on patients and carers one year after the stroke.