Click hyperlinks to access articles – sadly only some are full access

Stroke and General

The Taking Charge After Stroke (TaCAS) study main results (n=400) and meta-analysis of 2 RCTs (n=572). Predominantly European-ethnicity New Zealanders, 2-16 weeks after stroke and living in the community, who received one or two Take Charge sessions in addition to usual community rehabilitation, were significantly more likely to have better physical health, performing more advanced activities and more likely to be independent, 12 months after their stroke compared to those who received a control intervention. Meta-analysis of the MaPSS and TaCAS trials together (n=572) showed the number needed to treat (NNT) with Take Charge for one more person to be independent at 12 months after stroke was only eight (8).
[Fu, V., et al (2020). Taking Charge after Stroke: A randomized controlled trial of a person-centered, self-directed rehabilitation intervention. Int J Stroke,15(9), 954–964.] [Open access]

Editorial in Clinical Rehabilitation. Why person-centred rehabilitation is important and the lack of evidence supporting the current therapy-driven model of rehabilitation.
[McNaughton H, et al. (2022) A cohesive, person-centric evidence-based model for successful rehabilitation after stroke and other disabling conditions. Clinical Rehabilitation. 2022;0(0). doi:10.1177/02692155221145433] [Open Access]

The first study describing the concept of ‘Taking Charge’ and how it is important to people with a range of medical conditions, including stroke.
[McPherson, KM, et al (2004) Consequences of stroke, arthritis and chronic pain–are there important similarities? Disabil Rehabil 2004; 26:988–999.]

The first randomised controlled trial (stroke). The Māori and Pacific Stroke Study (MaPSS, n = 172). Māori and Pacific people discharged to community living and within 3 months of stroke who received one Take Charge session in addition to usual rehabilitation, were significantly more likely to have better physical health, more likely to be independent and their carers reported less strain at 12 months after stroke compared to those who received a control intervention.
[Harwood, M et al. (2012) Taking charge after stroke: promoting self-directed rehabilitation to improve quality of life – a randomised controlled trial. Clin Rehabil 2012; 26:493–501.]

How does Take Charge work?  An analysis of secondary data from the TaCAS trial and some of the theory behind Take Charge. Some evidence that Take Charge acts on baseline ‘ability to Take Charge’ to affect outcome. No evidence that Take Charge acts through improving mood.
[McNaughton, H et al (2021). The effect of the Take Charge intervention on mood, motivation, activation and risk factor management: Analysis of secondary data from the Taking Charge after Stroke (TaCAS) trial. Clin Rehab 2021: 35(7), 1021–1031.]

Economic analysis of the Taking Charge after Stroke study.  Headline figures of cost/QALY of £-25,000 (ie health utility gain AND cost saving) and point estimate of cost saving of about £1,000 in the first 12 months for each person treated with Take Charge.
[Te Ao B, et al. (2022) Economic analysis of the ‘Take Charge’ intervention for people following stroke: Results from a randomised trial. Clin Rehab. 2022;36(2):240-250. doi:10.1177/02692155211040727]

TaCAS study protocol (published before trial completed or data analysed)
[Fu VWY, et al (2017) The Taking Charge After Stroke (TaCAS) study protocol: a multicentre, investigator-blinded, randomised controlled trial comparing the effect of a single Take Charge session, two Take Charge sessions and control intervention on health-related quality of life 12 months after stroke for non-Māori, non-Pacific adult New Zealanders discharged to community living. BMJ Open. 2017 e016512. doi: 10.1136/bmjopen-2017-016512.]

Dr Matire Harwood’s PhD thesis informed by her work prior to and leading the Māori and Pacific Stroke Study. [Harwood, M. L. N. (2012). Understanding and Improving Stroke Recovery for Māori and Their Whānau (Thesis, Doctor of Philosophy). University of Otago. http://hdl.handle.net/10523/2514]

Dr Vivian Fu’s PhD thesis informed by her pivotal work with the Taking Charge after Stroke study. [Fu, V (2019) Taking Charge After Stroke: A novel, community-based intervention to improve the lives of people with stroke. (Thesis, Doctor of Philosophy) Victoria University, Wellington. https://researcharchive.vuw.ac.nz/handle/10063/8261]

An article describing some of the challenges in setting up and completing the TaCAS study. [Fu, V., & McNaughton, H., (2020). The taking charge after stroke study: How we tested a community stroke rehabilitation intervention in a randomized controlled trial. In SAGE Research Methods Cases: Medicine and Health. SAGE Publications, Ltd., https://doi.org/10.4135/9781529730937]

Intrinsic Motivation for everyday clinical use. A short article in Practical Neurology aimed at Neurologists and neurology teams but the principles apply much wider. McNaughton H, Fu V Intrinsic motivation Practical Neurology Published Online First: 31 July 2023. doi: 10.1136/pn-2023-003763

Chronic Obstructive Pulmonary Disease (COPD)

Making the case for using Take Charge for people with COPD. The concept of Take Charge can be applied to many medical conditions, not just stroke. Followed by a randomised feasibility study using Take Charge for people discharged from hospital after an acute exacerbation of COPD (see publications below)
[McNaughton A, et al. Taking Charge: A Proposed Psychological Intervention to Improve Pulmonary Rehabilitation Outcomes for People with COPD.Int J Chron Obstruct Pulmon Dis. 2020;15:2127-2133] (Open Access)

Take Charge for COPD: quantitative results from a randomised trial of Take Charge for people discharged from hospital after an acute exacerbation of COPD. Levack WMM, et al. Taking Charge After Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Randomized Controlled Feasibility Trial of a Psychologically Informed Self-Management Intervention. Int J Chron Obstruct Pulmon Dis. 2023;18:317-325 https://doi.org/10.2147/COPD.S393644 (Open access)

Take Charge for COPD: a qualitative study of participants in the randomised trial exploring beliefs about health and what keeps them well and out of hospital. [Hobman A, et al. Prevention of Re-Hospitalization for Acute Exacerbations: Perspectives of People with Chronic Obstructive Pulmonary Disease: A Qualitative Study. Int J Chron Obstruct Pulmon Dis. 2023;18:207-218
https://doi.org/10.2147/COPD.S393645] (Open access)

Outcome measures as part of Take Charge studies

The Hua Oranga instrument used for the first time as an outcome measure for Māori and Pacific people after stroke. [Harwood M, et al. An assessment of the Hua Oranga outcome instrument and comparison to other outcome measures in an intervention study with Māori and Pacific people following stroke. N Z Med J. 2012 Oct 26;125(1364):57-67. PMID: 23242398.]

Short Form 36 Physical Component Summary (SF36 PCS): estimating the minimal clinically important difference (MCID) for people with stroke for the first time. [Fu V, et al. Estimating the minimal clinically important difference for the Physical Component Summary of the Short Form 36 for patients with stroke. J Int Med Res. 2021. doi: 10.1177/03000605211067902.]