Stroke, Acute
Conditions
Keywords
Secondary prevention, Adjustment to life after stroke, Hidden impairments, Cognition, Mood, Fatigue
Brief summary
The goal of this feasibility study is to ascertain if this follow-up programme of care can feasibly be implemented within a healthcare system with people after minor stroke. The main feasibility questions are: i) To establish recruitment uptake ii) To establish treatment adherence iii) To determine participant retention. Participants will be randomly allocated to the intervention and control group. Those in the intervention group will receive a follow-up telephone call at two weeks after discharge and a second follow-up appointment at six weeks after discharge. Outcome measures will be taken at twelve weeks after discharge.
Interventions
BEHAVIORALPersonalised, holistic follow-up appointments underpinned by self determination theory
Appointment 1 (two weeks after discharge): * Address participants knowledge gaps as regards their stroke, medication and secondary prevention. * Detailed biopsychosocial review. * Understand participant priorities and jointly set goals. * Agreeing onward referrals if needed. * Written summary sent to GP with copy to participant. Appointment 2 (six weeks): * Review priorities identified in post stroke review checklist. * Review goals and plans from first appointment. * Address any new or persistent information gaps. * Review hidden impairments that may be impacting on return to work, activities of daily living, relationships or general well-being. * Agreeing onward referrals and action plan. * Written summary and plan sent to GP.
Sponsors
Imperial College Healthcare NHS Trust
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult ≥18 * Clinical or radiological diagnosis of minor stroke from a stroke consultant. * Admitted to HASU or seen in rapid assessment/TIA clinic. * Pre-admission mRS of 0-3 with no formal package of care prior to stroke. * Discharge mRS of 0-3. * No onward referral to community therapy team or for package of care. * Has capacity to consent.
Exclusion criteria
* Any serious co-morbidities that would impact a person's ability to participate in the follow-up appointments and outcome measurement. * Insufficient English to engage in intervention and outcome measures and no family or friends to support with this. * Not resident in England. * Pregnant women.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Retention rate | 12 weeks post randomisation | Proportion of participants that complete the follow-up questionnaires |
| Recruitment rate | Baseline | Proportion of participants randomised relative to the total number meeting the inclusion criteria. |
| Treatment completion rate | 6 weeks post randomisation | Proportion of participants who attend both follow-up appointments |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| MOCA | Baseline and 12 weeks | Cognitive assessment |
| GAD7 | 12 weeks | Anxiety score |
| PHQ9 | 12 weeks | Mood score |
| PROMIS10 | 2 weeks and 12 weeks | Patient reported outcome measures information system |
| Health Care Climate Questionnaire Short Form | Baseline and 12 weeks | Patient reported outcome measure |
Other
| Measure | Time frame | Description |
|---|---|---|
| Qualitative interviews | 13 weeks | Semi-structured |
Countries
United Kingdom
Contacts
Primary ContactJennifer Crow
Backup ContactParesh Malhotra
Outcome results
None listed