# A non-randomised controlled study of the missing link person-centred care transition support intervention after stroke or TIA

## TL;DR

A care transition support program improved perceived quality of care after stroke or TIA discharge, enhancing health confidence and literacy.

## Contribution

A multicomponent care transition support intervention was tested and shown to improve perceived quality of care transition in stroke/TIA patients.

## Key findings

- The intervention group reported significantly higher perceived quality of care transition compared to controls.
- Participants in the intervention group showed greater confidence in managing health and better medication understanding.

## Abstract

The transition from hospital to home after stroke or transient ischaemic attack (TIA) is a vulnerable phase marked by gaps in coordination, communication and patient preparedness. This study evaluated the effectiveness of a multicomponent care transition support on perceived quality of care transition (QCT) amongst people with stroke or TIA one week post-discharge. This non-randomised controlled study was conducted in three Swedish hospitals. Adult people with stroke or TIA discharged to home and referred for home-based neurorehabilitation were eligible. Data were collected during hospitalisation and at a blinded one-week follow-up. Primary outcome was perceived QCT, assessed with the Care Transition Measure. Secondary outcomes included health literacy, medication adherence and perception of received care. In total, 163 participants completed follow-up. The intervention group reported higher perceived QCT than controls (p = 0.002), which remained significant after adjustments (β = 6.34; 95% CI 0.56–12.12; p = 0.03). The intervention group reported greater confidence in managing health and better understanding of medications. Health literacy was higher in the intervention group, with no between-group differences in medication adherence or perception of received care. A multicomponent care transition support intervention may improve perceived QCT early after discharge in people with stroke or TIA.

The online version contains supplementary material available at 10.1038/s41598-026-45766-w.