Research priorities to improve stroke outcomes

Hill, Georgina; Regan, Sandra; Francis, Richard; Mead, Gillian; Thomas, Shirley; Salman, Rustam Al‐Shahi; Roffe, Christine; Pollock, Alex; Davenport, Sally; Kontou, Eirini; Chadd, Katie; Hammerbeck, Ulrike; Adebajo, Adewale; Lightbody, Catherine Elizabeth; Crow, Jenny; Kennedy, Niamh; Evans, Nicholas; Robinson, Thompson

doi:10.1016/s1474-4422(22)00044-8

Cited by 41 publications

(36 citation statements)

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“…The only self-reported outcome to decline over the period of one year was fatigue. Investigating causes of worsening fatigue is a top unmet need reported by both stroke survivors and clinicians 16 . While fatigue levels are not thought to be affected by time post-stroke 86 , these data suggest there may be an eventual worsening of fatigue in the very long-term.…”

Section: Discussionmentioning

confidence: 99%

“…Difficulties in any of these in early stroke are known to contribute to poorer quality of life, and may reduce daily activity participation 12,13 and increase need for carer support 4 . However, despite the recognized long-term importance of psychological outcomes [14][15][16] , research has been mainly limited to the first year post-stroke 13,17,18 .…”

Section: Introductionmentioning

confidence: 99%

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Long-term psychological outcomes following stroke: The OX-CHRONIC study

Kusec

Milosevich

Williams

et al. 2023

Preprint

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Introduction: Stroke survivors rate longer-term (>2 years) psychological recovery as their top priority, but data on how frequently psychological consequences occur is lacking. Prevalence of cognitive impairment, depression/anxiety, fatigue, apathy and related psychological outcomes, and whether rates are stable in long-term stroke, is unknown. Patients and Methods: N = 105 long-term stroke survivors (M [SD] age = 72.92 [13.01]; M [SD] acute NIHSS = 7.39 [6.25]; 59.0% Male; M [SD] years post-stroke = 4.57 [2.12]) were recruited (potential N = 208). Participants completed 3 remote assessments, including a comprehensive neuropsychological battery, and questionnaires on emotional distress, fatigue, apathy and other psychological outcomes. Ninety participants were re-assessed one year later. Stability of outcomes was assessed by Cohen's d and percent Minimal Clinically Important Difference changes between time points. Results: On the Montreal Cognitive Assessment 65.3% scored <26. On the Oxford Cognitive Screen 45.9% had at least one cognitive impairment. Attention (27.1%) and executive function (40%) were most frequently impaired. 23.5% and 22.5% had elevated depression/anxiety respectively. Fatigue (51.4%) and apathy (40.5%) rates were high. Attention (d = -0.12; 85.8% stable) and depression (d = 0.09, 77.1% stable) were the most stable outcomes. Only perceptuomotor abilities (d = 0.69; 40.4% decline) and fatigue (d = -0.33; 37.2% decline) worsened over one year. Cognitive impairment, depression/anxiety, fatigue and apathy all correlated with worse quality of life. Discussion: Nearly half of participants >2 years post-event exhibited psychological difficulties, which impact long-term quality of life. Conclusion: Stroke is a chronic condition requiring long-term psychological support.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term psychological outcomes following stroke: The OX-CHRONIC study

Kusec

Milosevich

Williams

et al. 2023

Preprint

Self Cite

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“…Similarly, McKevitt et al [ 14 ] estimated the prevalence of self-reported unmet needs in community-dwelling stroke survivors (n = 799) across the United Kingdom and found that 60% of those surveyed reported memory problems after stroke as an unmet need. A priority setting partnership in the UK, the James Lind Alliance, identified that cognitive impairment post-stroke was among the top priorities for stroke research [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring the perspectives of key stakeholders on the design and delivery of a cognitive rehabilitation intervention for people post-stroke

et al. 2022

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Purpose Stroke is a leading cause of death and disability worldwide. Despite the prevalence and associated burden of post-stroke cognitive impairment, there is uncertainty regarding optimum interventions to improve cognitive function in people post-stroke. The aim of this study is to explore the perspectives of key stakeholders on the design and development of a multidisciplinary intervention to rehabilitate cognitive deficits in people post-stroke. Materials and methods Audio-recorded, semi-structured interviews were employed with people post-stroke, caregivers, healthcare professionals and academics. All transcribed interviews were exported to NVivo software and analysed using reflexive thematic analysis. Results Thirty interviews were conducted across stakeholder groups including people post-stroke (n = 10), caregivers (n = 5), healthcare professionals (n = 14) and academics (n = 1). Four themes relevant to the design and development of the intervention were identified (i) engagement in the intervention must be meaningful, (ii) the point of readiness to engage, (iii) a familiar but flexible setting is key (iv) pragmatics of intervention delivery. Conclusions These findings present new perspectives across stakeholder groups on the design and delivery of an intervention to rehabilitate cognitive deficits in people post-stroke. Taken together with existing quantitative evidence, these findings will inform the development of a feasibility trial, examining patient and process outcomes, to rehabilitate cognitive deficits post-stroke.

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“…The consumer perspective is also key, and multi-disciplinary studies aiming to address research priorities highlighted by patient advocacy groups and clinicians are likely to deliver more impactful outcomes (e.g. [ 11 ]). We welcome submissions with this clear translational intent to this special collection.…”

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confidence: 99%

Cerebrovascular Disorders

Granata

Harshfield

Moxon

2023

BMC Cardiovasc Disord

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Cerebrovascular disorders pose a global health concern. Advances in basic and clinical research, including induced pluripotent stem cell models and multi-omic approaches, have improved our understanding and management of these disorders. However, gaps in our knowledge remain. BMC Cardiovascular Disorders invites authors to submit articles investigating what drives and affects Cerebrovascular disorders to improve patient care.

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Research priorities to improve stroke outcomes

Cited by 41 publications

References 3 publications

Long-term psychological outcomes following stroke: The OX-CHRONIC study

Long-term psychological outcomes following stroke: The OX-CHRONIC study

Exploring the perspectives of key stakeholders on the design and delivery of a cognitive rehabilitation intervention for people post-stroke

Cerebrovascular Disorders

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