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Trial registered on ANZCTR
Registration number
ACTRN12614000839606
Ethics application status
Approved
Date submitted
16/07/2014
Date registered
7/08/2014
Date last updated
7/08/2014
Type of registration
Retrospectively registered
Titles & IDs
Public title
An Implementation Project to Improve Identification Of Altered Mood for People Hospitalised After Acute Stroke
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Scientific title
Will patients with acute stroke who are admitted to a hospital providing the mood identification program have a greater likelihood of having altered mood identified than patients in hospitals providing standard care and when compared to an historical control period?
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Secondary ID [1]
284000
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Nil
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Universal Trial Number (UTN)
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Trial acronym
IAMAS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Stroke
291037
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Condition category
Condition code
Stroke
291375
291375
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0
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Ischaemic
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Stroke
291376
291376
0
0
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Haemorrhagic
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients with stroke and TIA admitted to intervention sites will be observed (from admission onwards) and screened (after 5 days) for altered mood. Screening will be undertaken using the Hospital Anxiety & Depression Scale (HADS) or for those with cognition/ communication issues the Behavioural Outcomes of Anxiety (BOA) and Stroke Aphasic Depression Questionnaire Hospital Version (SADQ-H10) tools. These will be repeated as clinically indicated. Staff will be trained in observation and screening. Evidence of identification of altered mood, including screen scores, will be recorded in the medical record.
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Intervention code [1]
288688
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Early detection / Screening
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Comparator / control treatment
The National Stroke Foundation Audit data from 2011 and 2013 will be used as historical comparative data for both Intervention and Control sites.
Both groups will also undertake a prospective, pre-implementation file audit for all patients admitted with stroke or TIA over a 5 week period.
The intervention will then be implemented at the Intervention sites, while the Control sites will continue with business as usual. No changes regarding identify altered mood will be trialled at these sites.
A repeat of the file audit will be undertaken at Intervention and Control sites 5 months after commencing the intervention.
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Control group
Active
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Outcomes
Primary outcome [1]
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Percentage of patients with stroke who have consideration of altered mood documented in their medical record
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Assessment method [1]
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Timepoint [1]
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At discharge
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Secondary outcome [1]
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Percentage of patients with stroke with a length of stay greater than or equal to 5 days who have undergone a screening of anxiety and depression
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Assessment method [1]
306615
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Timepoint [1]
306615
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At discharge
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Secondary outcome [2]
309361
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Percentage of intervention sites that have an identified individual/ s responsible for leading altered mood identification
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Assessment method [2]
309361
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Timepoint [2]
309361
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At commencement of intervention program
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Eligibility
Key inclusion criteria
Admitted with clinical signs of stroke or Transient Ischaemic Attack (TIA)
Participants located in a stroke unit or general ward
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
nil
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
This study is investigating the effectiveness of an implementation strategy to improve identification of altered mood after stroke.
It is a nonrandomised intervention comparison study with retrospective and prospective control groups (historical-control for within hospital change) and prospective control cohort (similar hospitals not providing the intervention)
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Descriptive statistics exploring differences in proportions for adherence to providing mood assessments (n adherence/ N eligible patients) using the Chi 2 test. Bivariable and multivariable regression analyses to assess for associations of patient or hospital characteristics with the likelihood of receiving a mood assessment with adjustment for patient clustering by hospital and differences in patient case-mix.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
19/05/2014
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Actual
19/05/2014
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Date of last participant enrolment
Anticipated
24/12/2015
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
200
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
2011
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John Hunter Hospital Royal Newcastle Centre - New Lambton
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Recruitment hospital [2]
2012
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The Maitland Hospital - Maitland
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Recruitment hospital [3]
2013
0
Calvary Mater Newcastle - Waratah
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Recruitment hospital [4]
2014
0
Belmont Hospital - Belmont
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Recruitment hospital [5]
2015
0
Manning Rural Referral Hospital (Taree) - Taree
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Recruitment hospital [6]
2016
0
Armidale Rural Referral Hospital - Armidale
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Recruitment hospital [7]
2017
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Tamworth Rural Referral Hospital - Tamworth
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Recruitment hospital [8]
2018
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Port Macquarie Base Hospital - Port Macquarie
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Recruitment hospital [9]
2019
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Gosford Hospital - Gosford
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Recruitment hospital [10]
2020
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Wyong Public Hospital - Hamlyn Terrace
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Recruitment postcode(s) [1]
7726
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2305 - New Lambton Heights
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Recruitment postcode(s) [2]
7727
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2320 - Maitland
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Recruitment postcode(s) [3]
8431
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2298 - Waratah
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Recruitment postcode(s) [4]
8432
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2280 - Belmont
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Recruitment postcode(s) [5]
8433
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2430 - Taree
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Recruitment postcode(s) [6]
8434
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2350 - Armidale
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Recruitment postcode(s) [7]
8435
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2340 - Tamworth
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Recruitment postcode(s) [8]
8436
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2444 - Port Macquarie
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Recruitment postcode(s) [9]
8437
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2250 - Gosford
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Recruitment postcode(s) [10]
8439
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2259 - Hamlyn Terrace
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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National Stroke Foundation
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Address [1]
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Level 7, 461 Bourke St
Melbourne. Victoria. 3000
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Country [1]
288627
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Australia
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Primary sponsor type
Government body
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Name
Hunter New England Local Health District
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Address
Lookout Rd,
New Lambton Heights,
NSW. 2305.
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Country
Australia
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Secondary sponsor category [1]
287334
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Government body
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Name [1]
287334
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Central Coast Local Health District
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Address [1]
287334
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Gosford Hospital
Holden Street
GOSFORD NSW 2250
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Country [1]
287334
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Australia
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Secondary sponsor category [2]
287335
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Government body
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Name [2]
287335
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North Coast Local Health District
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Address [2]
287335
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Morton Street
PORT MACQUARIE NSW 2444
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Country [2]
287335
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Australia
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Other collaborator category [1]
278050
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University
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Name [1]
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Monash University
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Address [1]
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Wellington Rd, Clayton VIC 3800
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Country [1]
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Australia
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Other collaborator category [2]
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University
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Name [2]
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University of Western Sydney
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Address [2]
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Hawkesbury Campus, College Dr, Richmond, NSW 2753
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Country [2]
278051
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Australia
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Other collaborator category [3]
278052
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Charities/Societies/Foundations
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Name [3]
278052
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Hunter Medical Research Institute
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Address [3]
278052
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1 Kookaburra Circuit, New Lambton Heights NSW 2305
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Country [3]
278052
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Australia
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Other collaborator category [4]
278053
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Charities/Societies/Foundations
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Name [4]
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National Stroke Foundation
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Address [4]
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Level 7, 461 Bourke St
Melbourne. Victoria. 3000
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Country [4]
278053
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Hunter New England Human Research Ethics Committee
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Ethics committee address [1]
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Research Ethics and Governance Unit District Headquarters- Administration Building Lookout Road, New Lambton, NSW. 2305.
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Ethics committee country [1]
290485
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Australia
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Date submitted for ethics approval [1]
290485
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29/11/2013
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Approval date [1]
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17/12/2013
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Ethics approval number [1]
290485
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13/12/11/4.01
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Summary
Brief summary
Altered mood is a common problem after stroke and can impact on stroke survivors’ recovery. Despite this it is often poorly identified by health professionals. Accessing psychology services after stroke is an enormous issue with only 12% of acute services having access to clinical psychology and 29% having protocols for referral to psychology. This pilot, implementation study aims to improve the identification of suspected altered mood in patients with stroke admitted to Hunter New England Health (HNEH) hub services. It will trial standardised processes and tools, supported by training for clinicians. Identification processes will commence early in the acute setting and continue during the stroke survivor's inpatient stay in HNEH hub facilities. Results from identifying suspected altered mood will be included in the patient discharge summary. This controlled, pre and post-implementation cohort design study will include comparisons to historical audit data and control sites.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Ms Di Marsden
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Address
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Hunter Stroke Service,
Level 2 , The Lodge
Rankin Park Campus,
Lookout Road,
New Lambton Heights.
NSW. 2305.
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Country
45894
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Australia
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Phone
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+61 2 49223380
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Fax
45894
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Email
45894
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[email protected]
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Contact person for public queries
Name
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Di Marsden
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Address
45895
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Hunter Stroke Service,
Level 2 , The Lodge
Rankin Park Campus,
Lookout Road,
New Lambton Heights.
NSW. 2305.
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Country
45895
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Australia
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Phone
45895
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+61 2 49223380
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Fax
45895
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Email
45895
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[email protected]
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Contact person for scientific queries
Name
45896
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Di Marsden
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Address
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Hunter Stroke Service,
Level 2 , The Lodge
Rankin Park Campus,
Lookout Road,
New Lambton Heights.
NSW. 2305.
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Country
45896
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Australia
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Phone
45896
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+61 2 49223380
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Fax
45896
0
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Email
45896
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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