Addressing unmet needs following minor stroke (SUN study): a randomised controlled trial

Emma Finch; Tegan Cruwys; Jennifer Fleming; Ian Williams; Ashley Cameron; Adele Coleman; Philip Aitken; Katherine Jaques; Darshan Shah

doi:10.1071/IB23074

RESEARCH ARTICLE (Open Access)

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Addressing unmet needs following minor stroke (SUN study): a randomised controlled trial

Emma Finch

^A ^B ^C ^D ^* , Tegan Cruwys ^E , Jennifer Fleming ^B , Ian Williams ^F , Ashley Cameron ^A , Adele Coleman ^B , Philip Aitken ^G ^H , Katherine Jaques ^G and Darshan Shah ^G

+ Author Affiliations

- Author Affiliations

^A Speech Pathology Department, Princess Alexandra Hospital, Brisbane, Qld, Australia.

^B School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia.

^C Research and Innovation, West Moreton Health, Ipswich, Qld, Australia.

^D Centre for Functioning and Health Research, Metro South Health, Brisbane, Qld, Australia.

^E Research School of Psychology, The Australian National University, Canberra, ACT, Australia.

^F Camp Hill Healthcare, Brisbane, Qld, Australia.

^G Division of Medicine, Princess Alexandra Hospital, Metro South Health, Brisbane, Qld, Australia.

^H School of Medicine, The University of Queensland, Brisbane, Qld, Australia.

^* Correspondence to: e.finch@uq.edu.au

Handling Editor: Grahame Simpson

Brain Impairment 25, IB23074 https://doi.org/10.1071/IB23074

Submitted: 14 September 2023 Accepted: 22 September 2023 Published: 19 January 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of the Australasian Society for the Study of Brain Impairment. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

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).

Keywords: acquired brain injury, discharge, mental health, mild stroke, randomised controlled trial, social participation, stroke, transition, unmet need, wellbeing.

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