Meeting unmet needs following minor stroke

Intervention: New service pathway: A multi-component pathway comprising: - Self-management kit: Immediately prior to hospital discharge patients will receive a written information pack from the research assistant (with verbal support at the time). Self-management programs are effective approaches in stroke management and are recommended in the new Stroke Foundation Clinical Guidelines for Acute Stroke Management. Additionally, there is a plethora of research suggesting that written information about stroke on discharge from hospital can be beneficial. The self-management kit will include written information about common difficulties specific to minor stroke, the need to see a General Prarctitioner (GP) after discharge from hospital for ongoing support, need for medications, referral to allied health services, and issues for the patient to discuss with their GP (via checklist). Participants will also receive the My Stroke Journey from the Stroke Foundation, which is a booklet available to all stroke patients that provides general stroke information. - Customised screening checklist: To encourage patients to be self-management experts in collaboration with their GP, patients will be provided with a checklist (as part of the self-management kit) to share with their GP. The checklist will include questions about services accessed and residual difficulties/changes post-stroke. There will be space in the checklist for the patient to add extra questions relevant to their individual situation. Use of the checklist to guide the consultation is optional. - Minor stroke community group: Patients will also be informed about a once-weekly minor stroke community group. The group will occur once a week for 1.5 hours at four different rotating locations. Group sessions have been identified as a critical ingredient of successful self-management programs in chronic disease. The group sessions will include brief information about common problems following minor stroke, need for medications, referral to allied health services if required, issues to discuss with GPs, and will have a guest speaker from a different health discipline each time (the role of the speakers will be to provide expert information about comments difficulties experienced within the topic by people with minor stroke and strategies that attendees can implement in their daily life. The speakers will be qualified health professionals e.g., dietician speaking about healthy eating after stroke, occupational therapist discussing return to driving). Information will be bite sized and patients will receive a short written summary to take home. The final part of the session will be social, providing patients with a chance to discuss issues, build relationships and receive peer support. This is a critical evidence-based component of effective chronic disease care, with our pilot finding that the most common impairments experienced following minor stroke were reduced social participation and mental health. These group sessions will also welcome carers. The group sessions will run in a series of approximately 8 sessions. Participants will be able to choose whether to attend specific or all sessions. Treatment fidelity will occur by audiotaping the sessions and then fidelity checking a random sample of 20% of sessions.