Review of evidence

We will review literature on the needs and experiences of stroke survivors and carers after hospital discharge, examining contact with primary care services after stroke, perceived roles of generalist care, and how local services are accessed. While there are existing reviews on needs and experiences, there has been less attention to views of patients and carers on primary care. The following literature reviews will be used to inform the new model of primary care.

Systematic review

This review aims to synthesise and appraise extant qualitative evidence on: (1) long-term healthcare needs of stroke survivors and informal carers, and (2) their experiences of primary care and community health services.

We will systematically search 4 databases: MEDLINE, EMBASE, PsycINFO and CINAHL for published qualitative evidence on the needs and experiences of stroke survivors and informal carers of post-acute care delivered by primary care and community health services. Additional searches of reference lists and citation indices will be conducted. Meta-ethnography will be used to synthesise the literature based on first-order, second-order and third-order constructs. We will construct a theoretical model of stroke survivors’ and informal carers’ experiences of primary care and community health services.

Scoping review

This review aims to provide an overview of: (1) primary care and community healthcare interventions by generalist healthcare professionals to stroke survivors and/or their informal carers to address long-term outcomes after stroke, (2) the scope and characteristics of interventions which were successful in addressing long-term outcomes, and (3) developments in current clinical practice.

Academic electronic databases will be searched to identify reviews of randomised controlled trials (RCTs) and controlled trials, trials from the past 5 years; reviews of observational studies. Practice exemplars from grey literature will be identified through advanced Google search. Reports, guidelines and other documents of major health organisations, clinical professional bodies, and stroke charities in the UK and internationally will be included. Data synthesis will include analysis of the number, type of studies, year and country of publication, a summary of intervention components/service or practice, outcomes addressed, main results (an indicator of effectiveness) and a description of included interventions.


We know that stroke survivors and their carers often struggle after they have been discharged from specialist services and their needs are not always identified or addressed by healthcare services; this is what we want to change.

– Dr Lisa Lim, Clinical Research Fellow and GP, Cardiovascular Group


Publications

  1. Aziz, N.A., Pindus, D.M., Mullis, R., Walter, F.M., Mant, J.M. (2016) Understanding stroke survivors’ and informal carers’ experiences of and need for primary care and community health services—a systematic review of the qualitative literature: protocol. BMJ Open, 6(1)
  2. Pindus D.M., Lim L, Rundell A.V., Hobbs V, Aziz N.A., Mullis R, Mant J.M. (2016) Primary care interventions and current service innovations in modifying long-term outcomes after stroke: a protocol for a scoping review. BMJ Open, 6(10)
  3. Pindus D.M., Mullis R, Lim L, Wellwood I, Rundell A.V., Aziz N.A., Walter F.M., Mant J.M. (2016) The experiences of and need for primary care and community health services in informal carers of stroke survivors – A systematic qualitative review. European Stroke Journal. 1(1_suppl):570
  4. Pindus D.M., Mullis R, Lim L, Wellwood I, Rundell A.V., Aziz N.A., Walter F.M., Mant J.M. (2016) Stroke survivors’ experiences of and need for primary care and community health services – A systematic qualitative review. European Stroke Journal. 1(1_suppl):570
  5. Pindus D.M., Mullis R, Lim L, Wellwood I, Kreit E, Lim L, Mant J.M. (2017) Primary care interventions for long-term outcomes after stroke: a scoping review of reviews and recent trials. European Stroke Journal. 2(1_suppl):453
  6. Kreit E, Pindus D.M., Mullis R, Chowienczyk S, Mant J.M. (2017) Clinical practice guidelines for stroke rehabilitation and long-term management: similarities and differences in recommendations for mood, aphasia and cognitive deficits. European Stroke Journal. 2(1_suppl):372
  7. Chowienczyk S, Nguyen Q, Pindus D.M., Kreit E. Mant J.M, Mullis R. (2017) A comparison of national guidelines for secondary prevention of ischaemic stroke. European Stroke Journal. 2(1_suppl):347
  8. Pindus D.M., Mullis R.,  Lim L.,  Wellwood I., Rundell A.V.,  Aziz N.A., Mant J. (2018) Stroke survivors’ and informal caregivers’ experiences of primary care and community healthcare services – A systematic review and meta-ethnography. PLOS ONE, 13(2)

Outputs

Systematic review posters

           

Scoping review posters

Review of stroke guidelines posters