Patients' experience of and participation in a stroke self-management programme, My Life After Stroke (MLAS): a multimethod study

BMJ Open. 2022 Nov 15;12(11):e062700. doi: 10.1136/bmjopen-2022-062700.

Abstract

Objective: A self-management programme, My Life After Stroke (MLAS), was developed to support stroke survivors. This evaluation reports patients' experience.

Design: Multimethod, involving interviews and questionnaires.

Setting: 23 general practices in the intervention arm of a cluster randomised controlled trial in East of England and East Midlands, UK.

Participants: People on the stroke registers of participating general practices were invited to attend an MLAS programme.

Interventions: MLAS comprises one-to-one and group-based sessions to promote independence, confidence and hope.

Primary and secondary outcome measures: The primary outcome was uptake of the programme. Participants who declined MLAS were sent a questionnaire to ascertain why. Attendees of four programmes completed evaluation forms. Attendees and non-attendees of MLAS were interviewed. Ad-hoc email conversations with the lead author were reviewed. Thematic analysis was used for qualitative data.

Results: 141/420 (34%) participants (mean age 71) attended an MLAS programme and 103 (73%) completed 1. 64/228 (28%) participants who declined MLAS gave reasons as: good recovery, ongoing health issues, logistical issues and inappropriate. Nearly all attendees who completed questionnaires felt that process criteria such as talking about their stroke and outcomes such as developing a strong understanding of stroke had been achieved.

Conclusions: MLAS was a positive experience for participants but many stroke survivors did not feel it was appropriate for them. Participation in self-management programmes after stroke might be improved by offering them sooner after the stroke and providing a range of delivery options beyond group-based, face-to-face learning.

Trial registration number: NCT03353519, NIH.

Keywords: PRIMARY CARE; PUBLIC HEALTH; Stroke.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cost-Benefit Analysis
  • General Practice*
  • Humans
  • Quality of Life
  • Self-Management*
  • Stroke* / therapy
  • Surveys and Questionnaires
  • Survivors

Associated data

  • ClinicalTrials.gov/NCT03353519