Protocol for a feasibility registry-based randomised controlled trial investigating a tailored follow-up service for stroke (A-LISTS)
Creators: name: Cadilhac, Dominique A
name: Ross, Andrew
name: Bagot, Kathleen L
name: Blennerhassett, Jannette M
name: Kilkenny, Monique F
name: Kim, Joosup
name: Purvis, Tara
name: Barclay, Karen
name: Ellery, Fiona
name: Morrison, Julie
name: Cranefield, Jennifer
name: Kleinig, Timothy J
name: Grimley, Rohan
name: Jaques, Katherine
name: Wong, Dana
name: Murphy, Lisa
name: Russell, Grant
name: Nelson, Mark R
name: Thijs, Vincent
name: Scott, Colin
name: Middleton, Sandy
Publisher: name: La Trobe
Year: 2024
Subjects: classificationCode: 42
subject: Health sciences
subject: FOS: Health sciences
classificationCode: 320905
subject: Neurology and neuromuscular diseases
classificationCode: 4203
subject: Health services and systems
classificationCode: 321402
subject: Clinical pharmacology and therapeutics

description: 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. Trial sponsor: Florey Institute of Neuroscience and Mental Health, 245 Burgundy Street, Heidelberg, VIC, 3084, PH: +61 3 9035 7032