Discussion
®, Stroke, ’, stroke, Rehabkompassen®, disability
ADVERSE EFFECTS, STROKE, RECRUITMENT, STROKE
Stroke is a leading cause of disability among adults worldwide, with a heavy burden for patients and their families as well as society [To meet these challenges, Rehabkompassen® was recently created and developed as a novel and unique digital follow-up tool to identify and graphically visualize a panoramic view of stroke patients’ heterogeneous rehabilitation needs based on 6 well-validated and reliable PROMs [This two-arm pragmatic multisite study will be able to provide unequivocal results of the eventual effectiveness of the Rehabkompassen tool since both the intervention and control are used in normal practice. Moreover, this trial provides substantial flexibility concerning the adaptation of the Rehabkompassen tool into everyday clinical practice, such as stroke units, early support discharge units and stroke rehabilitation units, in the post-acute continuum of care after stroke in Sweden. A multicentre study also means extra attention should be given to ensure the minimization of the differences and variations among clinics. This is why we will collect baseline data concerning usual care and provide the study information and a training program on the usage of Rehabkompassen® and REDCap prior to patient recruitment. In addition, much information about implementation will be collected from medical practitioners in the participating clinics in the proposed study. Together with the high generalizability of the pragmatic trial [Despite the potential usefulness of the tool, there are various practical and operational issues to consider in this study. We are certainly aware of the major challenge of recruiting more than 1000 patients, which is required for the power analysis. Our pilot study demonstrated a recruitment rate of 28% with a retention rate of 86% at the 12-month follow-up without any severe adverse effects during the heavy pandemic period [We are also aware of the challenge of running such a large multicentre study, especially concerning data collection and management, which is why a separate data management plan has been established and kept at Umeå University. Another issue is technical obstacles for the participants, who are often elderly since the mean age of stroke patients is 73 years old [This study will provide strong evidence on the effectiveness and cost-effectiveness of a novel digital follow-up tool, Rehabkompassen®, in persons discharged from acute care settings after stroke. In addition to improving the tool to be more user -riendly, we envisage finding a cost-effective solution to carry out standard follow-up visits and to facilitate patient-tailored rehabilitation in persons with stroke in current clinical practice. This tool has the potential to improve everyday life for many stroke patients and to reduce the health, social and economic burdens after stroke for patients and their families as well as society. The outcomes of this trial will inform clinical practice and health care policy on the role of the digital follow-up tool Rehabkompassen® in the post-acute continuum of care after stroke.