ImProving Outcomes after STroke (POST): results from the randomized clinical pilot trial.
BACKGROUND
One in three patients experience depression after stroke. An effective strategy to prevent depression after stroke that could be economically delivered to most patients with a low likelihood of adverse events is needed.


METHODS
In a randomized trial conducted in New South Wales, Australia, a postcard was sent monthly to participants (n = 100) for five-months following hospital discharge after stroke (plus usual care) and compared with usual care (n = 101). Ethical approval was obtained to withhold information about the intervention and primary outcome from participants during the consent process.


RESULTS
No significant difference was seen in the proportion of participants with depression in the intervention group (1/88) vs. the control group (3/76) (relative risk 0·29, 95% confidence interval 0·03-2·71) at six-months. No significant differences were seen on Hospital Anxiety Depression Scale (HADS) depression and anxiety sub-scale scores, quality of life, or activities of daily living; however, many (47/100) responded positively to the postcards.


CONCLUSIONS
Although this simple postcard intervention did not significantly reduce the proportion of participants experiencing high HADS depression sub-scale scores after stroke, it may be an effective way to engage with people after stroke following hospital discharge.
The George Institute for Global Health, The University of Sydney, Sydney, NSW, Australia.
Maree L
ML
Hackett
Greg
G
Carter
Denis
D
Crimmins
Tracy
T
Clarke
Lucy
L
Arblaster
Laurent
L
Billot
Jayanthi
J
Mysore
Jonathan
J
Sturm
D000368:Aged; D003863:Depression / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011177:Postal Service; D011580:Psychological Techniques; D020521:Stroke / Q000150:complications / Q000523:psychology*