None listed
Conditions
Brief summary
A new treatment for patients with acute stroke has recently been established at Auckland District Health Board and is increasingly being used nationwide. Clot retrieval involves removing the clot using either suction aspiration or a stent. Successful clot retrieval allows the return of blood flow to the stroke-affected areas of the brain and results in significantly better outcomes for just over half of people treated. While the benefits of clot retrieval for physical outcomes after stroke have been established, it is not clear whether patients continue to experience difficulties with their memory and thinking, fatigue or mood. Even mild issues in these areas present barriers to the person with stroke returning to work and their usual activities. The purpose of this study is to identify any unmet cognitive or psychological needs in patients after clot retrieval and to find out whether these issues are affecting their return to work or their usual activities. Up to 160 patients who live in the Auckland metro region and have clot retrieval at Auckland City Hospital will be invited to take part. At 3 months after stroke, patients will complete questionnaires and undergo clinical assessments to help us understand their experience of clot retrieval and identify any ongoing issues with cognition, mood and fatigue. Up to 40 people will also be invited to take part in a more detailed interview about their experiences. Establishing the level of need in this unique patient group will help District Health Boards nationwide tailor community rehabilitation services to support patients who have this new and important stroke treatment.
Interventions
Up to 160 adults who receive clot retrieval for stroke will be contacted via letter and phone call at 2 months post-stroke and invited to participate. Patients must live in the Auckland metropolitan area (Auckland, Waitemata and Counties Manukau DHB catchments). Participants will complete a single session of assessments at 3 months post stroke. This session will take place in person at a location the patient chooses (their home, Auckland City Hospital, or another place of their choosing).
Part
Up to 160 adults who receive clot retrieval for stroke will be contacted via letter and phone call at 2 months post-stroke and invited to participate. Patients must live in the Auckland metropolitan area (Auckland, Waitemata and Counties Manukau DHB catchments). Participants will complete a single session of assessments at 3 months post stroke. This session will take place in person at a location the patient chooses (their home, Auckland City Hospital, or another place of their choosing). Participants will be asked to complete a study-specific questionnaire about their clot retrieval experience and any ongoing concerns about cognition, mood, or fatigue. A subset of 40 participants will also be interviewed for more detailed responses. 20 participants who discharged directly home from the acute stroke service will be interviewed, and 20 who completed inpatient rehabilitation prior to discharge. Purposive sampling of patients who identify as Maori, Pasifika or Asian will be used. The interview will be audio recorded and transcribed for thematic analysis. Patients can choose to have a family member present and participating in the interview. Family members who choose to participate will provide written informed consent and are considered participants in the study. The interview is anticipated to take between 20 and 30 minutes. After completing the questionnaire and interview (if appropriate), participants will complete clinical assessments of cognition (Addenbrookes Cognitive Evaluation III NZ version), fatigue (Fatigue Impact Scale), mood (Hospital Anxiety and Depression Scale), disability (modified Ranking Scale) and quality of life (Stroke Impact Scale). The questionnaire, interview and clinical assessments will be completed by an experienced clinical assessor (occupational therapist or physiotherapist). This single session is anticipated to take 1.5 hours for most participants, and 2 hours for the subset who also complete the interview.
Sponsors
Auckland District Health Board
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adults who had clot retrieval for stroke at Auckland City Hospital within last 2 months. Live within the Auckland Metro area (Auckland, Waitemata and Counties Manukau District Health Boards) Pre-stroke mRS (modified Rankin Scale) less than 3
Exclusion criteria
Discharged from the acute service directly to residential care facility Severe communication or cognitive deficits preclude ability to provide informed consent Life expectancy less than 6 months
Outcome results
None listed