Abstract Background and aims The Take Charge intervention (TC) is a conversation-based, community intervention shown to improve independence, and physical health 12 months after stroke in the TaCAS study. (Taking Charge After Stroke). The TaCAS study recruited 400 participants discharged after stroke, randomized within 16 weeks to one of 3 groups: 1 TC session, 2 sessions 6 weeks apart, or no sessions (control). Methods This paper reports long-term outcomes of TaCAS participants 5-6 years after their index stroke who are still alive and willing to answer questions. Outcomes were collected by postal questionnaire or telephone call. The primary outcome was the Physical Component Summary (PCS) of the Short Form 36, comparing TC and control. Secondary outcomes were: Frenchay Activities Index (FAI); modified Rankin Scale (mRS); survival; and stroke recurrence. Outcomes were compared with those 12 months after stroke. Analysis was by ANOVA or logistic regression. Results Mortality data were available for all 400 participants; functional data for 204/297 (69%) of survivors. The mean difference (95% CI) in PCS between TC and control groups was 2.8 (−0.8 to 6.5) units, P = 0.12, and for independence (mRS score, 0–2) the odds ratio (95% CI) was 0.56 (0.28–1.16), P = 0.11, both favoring TC with similar point estimates to those after 12 months. Differences between TC and control participants for FAI scores, survival, and stroke recurrence were small and nonsignificant. Conclusions The clinically significant improvements in physical health and independence for TC participants, observed at 12 months, were sustained 5 to 6 years after stroke, but no longer statistically significant. Conflict of interest Alexander Martin: nothing to disclose.
Martin et al. (Fri,) studied this question.