Title: Supported Communication to Improve Participation in Rehabilitation of people with moderate-severe aphasia after a first stroke: a pilot study (SCIP-R)
Funder: Department of Health (England)

Abstract: Background Stroke has serious cost implications for UK health and social care. About 33% of first time stroke patients have aphasic communication disorders, associated with longer hospital stays. These patients may not fully benefit from rehabilitation, being unable to understand questions, follow instructions or express needs. Information must be communicated in particular ways to be accessible, and they may need help setting meaningful goals. Staff do not necessarily have the skills to support patients in these ways. ‘Supported communication’ uses a set of techniques to help make communication more accessible. It has been found to help, but there is little research into its use in clinical contexts. It could be used by any member of the stroke team to help patients participate more fully. Aims This project aims to: 1) Perform an exploratory cluster controlled observer-blinded trial to evaluate the use, utility and value for money of supported communication in patients with moderate-severe aphasia after stroke; 2) Examine the views and experiences of stroke unit staff towards implementation of the intervention; 3) Examine the views and satisfaction of people with aphasia towards the use of supported communication; 4) Gain data for the development of a definitive RCT to further determine the effectiveness and cost-effectivesness of using supported communication as an intervention to improve outcomes for people with aphasia after stroke. Plan of Investigation An exploratory RCT (supported communication enhanced care vs routine care) will be carried out. Participants will be 50 patients with moderate-severe aphasia admitted each from two post-acute stroke units (intervention / control). Observational and self-report report measures will be collected on admission to and discharge from the units and at 6 month follow-up. A training protocol for the experimental intervention will be developed, and staff trained in its use. A qualitative study of staff attitudes to the intervention will be carried out, and patient satisfaction measured. Outcome measures: patient participation and engagement; health-related quality of life; EQ-5D Potential Impact Supported communication is an effective means of enabling social participation of people with aphasia. The value of supported communication in the clinical context of stroke rehabilitation has not been tested. We believe that it may produce direct and tangible benefit to patients with moderate-severe aphasia after stroke when deployed by members of the stroke team. It has the potential to reduce frustration of patients with aphasia and enable them to benefit more fully from the rehabilitation available, with improved physical, psychosocial and health-related outcomes. The results of this study have the potential to change stroke care practice and provide better quality of care to these patients. A key output will be a well-defined protocol for a more definitive Phase III trial.


Research activity codes: 6.7 PHYSICAL
Health categories: STROKE