Activity and Life After Survival of a Cardiac Arrest (ALASCA) and the effectiveness of an early intervention service: design of a randomised controlled trial.
BACKGROUND
Cardiac arrest survivors may experience hypoxic brain injury that results in cognitive impairments which frequently remain unrecognised. This may lead to limitations in daily activities and participation in society, a decreased quality of life for the patient, and a high strain for the caregiver. Publications about interventions directed at improving quality of life after survival of a cardiac arrest are scarce. Therefore, evidence about effective rehabilitation programmes for cardiac arrest survivors is urgently needed. This paper presents the design of the ALASCA (Activity and Life After Survival of a Cardiac Arrest) trial, a randomised, controlled clinical trial to evaluate the effects of a new early intervention service for survivors of a cardiac arrest and their caregivers.


METHODS
The study population comprises all people who survive two weeks after a cardiac arrest and are admitted to one of the participating hospitals in the Southern part of the Netherlands. In a two-group randomised, controlled clinical trial, half of the participants will receive an early intervention service. The early intervention service consists of several consultations with a specialised nurse for the patient and their caregiver during the first three months after the cardiac arrest. The intervention is directed at screening for cognitive problems, provision of informational, emotional and practical support, and stimulating self-management. If necessary, referral to specialised care can take place. Persons in the control group will receive the care as usual. The primary outcome measures are the extent of participation in society and quality of life of the patient one year after a cardiac arrest. Secondary outcome measures are the level of cognitive, emotional and cardiovascular impairment and daily functioning of the patient, as well as the strain for and quality of life of the caregiver. Participants and their caregivers will be followed for twelve months after the cardiac arrest.A process evaluation will be performed to gain insight into factors that might have contributed to the effectiveness of the intervention and to gather information about the feasibility of the programme. Furthermore, an economic evaluation will be carried out to determine the cost-effectiveness and cost-utility of the intervention.


CONCLUSIONS
The results of this study will provide evidence on the effectiveness of this early intervention service, as well as the cost-effectiveness and its feasibility.


BACKGROUND
Current Controlled Trials [ISRCTN74835019].
Moulaert
Véronique R M P
VR
Rehabilitation Foundation Limburg, Hoensbroek, The Netherlands. v.moulaert@srl.nl
Verbunt
Jeanine A
JA
van Heugten
Caroline M
CM
Bakx
Wilbert G M
WG
Gorgels
Anton P M
AP
Bekkers
Sebastiaan C A M
SC
de Krom
Marc C F T M
MC
Wade
Derick T
DT
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D017028:Caregivers / Q000523:psychology; D003072:Cognition Disorders / Q000191:economics / Q000209:etiology* / Q000451:nursing / Q000523:psychology; D003362:Cost-Benefit Analysis; D004644:Emotions; D005240:Feasibility Studies; D007722:Health Knowledge, Attitudes, Practice; D006323:Heart Arrest / Q000150:complications / Q000191:economics / Q000451:nursing* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D002534:Hypoxia, Brain / Q000150:complications* / Q000191:economics / Q000209:etiology / Q000451:nursing / Q000503:physiopathology / Q000523:psychology; D009426:Netherlands; D009723:Nurse-Patient Relations; D010353:Patient Education as Topic; D017064:Process Assessment, Health Care; D015397:Program Evaluation; D011788:Quality of Life; D020127:Recovery of Function; D012017:Referral and Consultation / Q000191:economics; D012107:Research Design; D012648:Self Care; D012944:Social Support; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013997:Time Factors; D016896:Treatment Outcome