Addressing unmet needs following minor stroke (SUN study)

Abstract

Background: Growing evidence suggests that people with minor stroke experience persisting post-stroke impairments across a range of domains. Our primary aim was to determine whether a new multicomponent intervention for people with minor stroke reduced unmet needs at 1 and 3 months post-hospital discharge compared with usual care. Secondary aims explored the efficacy of the intervention on functional outcomes, health-related quality of life, return to work and social group membership. Methods: A parallel, randomised controlled trial design with 1:1 allocation to the intervention and control groups (n = 34 per group) was used. The intervention group received a multicomponent intervention (comprising information about minor stroke, checklist and group education sessions). The control group received usual care. Participants completed assessments at baseline (T1), 1 month (T2) and 3 months (T3) post-hospital discharge. The primary outcome measure was unmet need according to the Survey of Unmet Needs and Service Usage. Results: The intervention did not significantly reduce unmet need (P = 0.839); however, the control group reported a significant need for existing support to continue (P = 0.032). Participation in the intervention led to significant improvements in emotional wellbeing compared to the control group (P = 0.041). There was no difference between the groups according to social participation, health-related quality of life, return to work or social group membership (all P > 0.05). Usage of the three intervention components was lower than anticipated. Conclusions: A suite of mixed format, evidence-based education and support tools did not fully meet the unmet needs of minor stroke survivors during their transition from hospital. Further research is required to refine the intervention. Clinical trial registration: Prospectively registered - Australian New Zealand Clinical Trials Registry (ACTRN12619000133134p). Show more