Access to rehabilitation after stroke in Brazil (AReA study): multicenter study protocol

Abstract

Background Most of the Brazilian population relies on public healthcare and stroke is a major cause of disability in this country of continental dimensions. There is limited information about access to rehabilitation after stroke in Brazil.

Objective To provide comprehensive information about Access to Rehabilitation After discharge from public hospitals in Brazil (AReA study), up to 6 months after stroke.

Methods The present study intends to collect information from 17 public health centers in 16 Brazilian cities in the 5 macroregions of the country. Each center will include 36 participants (n = 612). The inclusion criteria are: age ≥ 18 years old; ischemic or hemorrhagic stroke, from 6 months to 1 year prior to the interview; admission to a public hospital in the acute phase after stroke; any neurological impairment poststroke; patient or caregiver able to provide informed consent and answer the survey. Patients can only be recruited in public neurology or internal medicine outpatient clinics. Outcomes will be assessed by a standard questionnaire about rehabilitation referrals, the rehabilitation program (current status, duration in months, number of sessions per week) and instructions received. In addition, patients will be asked about preferences for locations of rehabilitation (hospitals, clinics, or at home).

Trial Status The study is ongoing. Recruitment started on January 31^st, 2020 and is planned to continue until June 2022.

Conclusion The AReA study will fill a gap in knowledge about access to stroke rehabilitation in the public health system in different Brazilian regions.

Resumo

Antecedentes Grande parte da população brasileira depende de saúde pública e o acidente vascular cerebral (AVC) é uma das principais causas de incapacidade neste país de dimensões continentais. As informações sobre o acesso à reabilitação após AVC em instalações públicas no Brasil são limitadas.

Objetivo Fornecer informações abrangentes sobre o Acesso à Reabilitação pós-AVC (estudo AReA) nos primeiros 6 meses após a alta hospitalar da rede pública.

Métodos Serão coletadas informações de 17 centros de saúde públicos em 16 cidades brasileiras das cinco macrorregiões do país. Cada centro incluirá 36 participantes (n = 612). Os critérios de inclusão são: idade ≥ 18 anos; AVC isquêmico ou hemorrágico, com tempo de lesão entre 6 meses e 1 ano; admissão em hospital público na fase aguda; qualquer comprometimento neurológico pós-AVC; paciente ou cuidador capaz de fornecer consentimento informado e responder à pesquisa. Os pacientes só podem ser recrutados em ambulatórios públicos de neurologia ou medicina interna. Os resultados serão avaliados por um questionário padrão sobre encaminhamentos de reabilitação, o programa de reabilitação (estado atual, duração em meses, número de sessões por semana) e instruções recebidas. Além disso, os pacientes serão questionados sobre as preferências de locais de reabilitação (hospitais, clínicas ou casa).

Status do estudo O estudo está em andamento. O recrutamento começou em 31 de janeiro de 2020 e está previsto para continuar até junho de 2022.

Conclusão O estudo AReA preencherá uma lacuna no conhecimento sobre o acesso à reabilitação para AVC no sistema público de saúde em diferentes regiões brasileiras.

Keywords

Stroke - Patient Discharge - Referral and Consultation - Rehabilitation

Palavras-chave

Acidente Vascular Cerebral - Alta do Paciente - Encaminhamento e Consulta - Reabilitação

Authors' Contributions

ROC, ABC: conceptualization, writing, review, editing, and validation of the original draft; CHCM, RB, SNFG, EBP, SMMSA, LV, KJA, TSR, RVBMJ, CM, MEPP, EHAP, MTAP, OMPN, APF, ASP: review, editing, and validation of the original draft.

Publikationsverlauf

Eingereicht: 29. September 2021

Angenommen: 05. Februar 2022

Artikel online veröffentlicht:
19. Dezember 2022

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