Care priorities for stroke patients developing cognitive difficulties: a Delphi survey of UK professional views

Tang, Eugene Y. H., Robinson, Louise, Exley, Catherine, Flynn, Darren, Stephan, Blossom C. M. and Price, Christopher (2020) Care priorities for stroke patients developing cognitive difficulties: a Delphi survey of UK professional views. BMC Health Services Research, 20 (1). p. 717. ISSN 1472-6963

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Background: Post stroke cognitive difficulties are common but generally prioritised below other impairments. In the UK, clinical guidelines recommend a holistic review at six-months post-stroke including an assessment of cognitive function. In order to assist clinicians to provide better care for patients with post-stroke cognitive deficits and assist with service planning, our aim was to establish professional consensus on key actions at the six-month review. Methods: An electronic Delphi survey was developed with ten potential actions for clinicians to prioritise across five different clinical scenarios describing patients with cognitive difficulties. Scenarios varied in terms of age of the stroke-survivor, stroke severity and use of dementia risk assessment. A panel of professional volunteers was obtained through the British Association of Stroke Physicians and the UK National Stroke Nursing Forum. Results: Forty-five stroke clinicians completed round one, with 21 participants completing round two. Priorities consistently supported by professionals included access to psychological services, screening for a mood disorder and ensuring multi-professional input. Direct access to specialist memory services was not generally supported unless a dementia risk assessment tool indicated that the individual was at high risk of dementia. Conclusions: Assessment of post-stroke cognitive deficits needs to be routinely considered during the six-month review. A formal risk assessment tool could be a way to streamline direct access to memory clinic services to ensure that individuals at-risk of dementia receive ongoing care.

Item Type: Article
Additional Information: Funding Information: ET is supported by a National Institute for Health Research (NIHR) Doctoral Research Fellowship (DRF-2015-08-006) for this project. The funding body had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. LR is supported by a NIHR Senior Investigator award (NF-SI-0616-10054). CP receives support from a fellowship awarded by the Stroke Association, UK (TSA LECT 2017/03).
Uncontrolled Keywords: Cognition, Delphi, Dementia, Risk assessment, Stroke
Subjects: A300 Clinical Medicine
B100 Anatomy, Physiology and Pathology
B700 Nursing
B900 Others in Subjects allied to Medicine
Department: Faculties > Health and Life Sciences > Nursing, Midwifery and Health
Depositing User: Rachel Branson
Date Deposited: 10 Nov 2021 10:22
Last Modified: 10 Nov 2021 10:30

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