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Protocol for a feasibility registry-based randomised controlled trial investigating a tailored follow-up service for stroke (A-LISTS)

  • Dominique A. Cadilhac
  • , Andrew G. Ross
  • , Kathleen L. Bagot
  • , Jannette M. Blennerhassett
  • , Monique F. Kilkenny
  • , Joosup Kim
  • , Tara Purvis
  • , Karen M. Barclay
  • , Fiona Ellery
  • , Julie Morrison
  • , Jennifer Cranefield
  • , Timothy J. Kleinig
  • , Rohan Grimley
  • , Katherine Jaques
  • , Dana Wong
  • , Lisa Murphy
  • , Grant Russell
  • , Mark R. Nelson
  • , Vincent Thijs
  • , Colin Scott
  • Sandy Middleton, on behalf of the A-LISTS investigator group

Research output: Contribution to journalArticleOtherpeer-review

Abstract

Background: Stroke affects long-term physical and cognitive function; many survivors report unmet health needs, such as pain or depression. A hospital-led follow-up service designed to address ongoing health problems may avoid unplanned readmissions and improve quality of life. Methods: This paper outlines the protocol for a registry-based, randomised controlled trial with allocation concealment of participants and outcome assessors. Based on an intention-to-treat analysis, we will evaluate the feasibility, acceptability, potential effectiveness and cost implications of a new tailored, codesigned, hospital-led follow-up service for people within 6–12 months of stroke. Participants (n = 100) from the Australian Stroke Clinical Registry who report extreme health problems on the EuroQol EQ-5D-3L survey between 90 and 180 days after stroke will be randomly assigned (1:1) to intervention (follow-up service) or control (usual care) groups. All participants will be independently assessed at baseline and 12–14-week post-randomisation. Primary outcomes for feasibility are the proportion of participants completing the trial and for intervention participants the proportion that received follow-up services. Acceptability is satisfaction of clinicians and participants involved in the intervention. Secondary outcomes include effectiveness: change in extreme health problems (EQ-5D-3L), unmet needs (Longer-term Unmet Needs questionnaire), unplanned presentations and hospital readmission, functional independence (modified Rankin Scale) and cost implications estimated from self-reported health service utilisation and productivity (e.g. workforce participation). To inform future research or implementation, the design contains a process evaluation including clinical protocol fidelity and an economic evaluation. Discussion: The results of this study will provide improved knowledge of service design and implementation barriers and facilitators and associated costs and resource implications to inform a future fully powered effectiveness trial of the intervention. Trial registration: ACTRN12622001015730pr.

Original languageEnglish
Article number103
Number of pages12
JournalPilot and Feasibility Studies
Volume10
Issue number1
DOIs
Publication statusPublished - 30 Jul 2024

Keywords

  • Clinical Quality Registry
  • Clinical trial protocol
  • Follow-up service
  • Stroke

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