SUPPORT TIA

It is important that people who have a mini stroke (TIA)/ minor stroke receive adequate healthcare and support. This includes:

• Making sure people understand their diagnosis;
• Giving medication and lifestyle advice to reduce risk of future strokes;
• Supporting other impacts of mini stroke (TIA) or minor stroke, such as anxiety or tiredness.

Follow-up care is not currently standardised for these patients. Therefore, people have different experiences of care depending on what hospital or GP practice they attend.

We want to find out if healthcare could be improved by having a follow-up appointment to discuss healthcare needs and support, with a nurse or therapist, four weeks after having a mini stroke (TIA) or minor stroke.

Before we do a large trial to see if the intervention is effective, we first need to do a smaller study to see if the intervention is feasible and if patients’ find it acceptable and helpful.

Study design: randomised (1:1) feasibility study.

Participants will be randomised to:

1. Receive treatment and care which is currently offered to people after mini stroke (TIA) or minor stroke (Control Group)

OR

1. Receive treatment and care which is currently offered to people after mini stroke (TIA) or minor stroke AND have a follow-up appointment with a nurse or therapist four weeks into the study (Intervention Group).

What data will be collected?

Baseline: Medical history, demographic information (e.g. age, ethnicity, sex) and contact details.

Follow-up:

• 1, 12 and 24 weeks: Questions about mood, fatigue (tiredness), quality of life, medication and healthcare/ support.
• End of study clinic appointment (26 weeks): blood pressure, weight, medications and blood test to measure cholesterol.

 

Sub-study: A subset of participants from both groups will be invited to attend an interview with a researcher to talk about their experience of taking part in the study. 

Participants will be invited to attend a follow-up appointment with a nurse or therapist about 4 weeks into the study.

The appointment will be at the hospital’s mini stroke (TIA) clinic and last about 30 minutes. If visits to hospitals are restricted due to COVID-19, the appointment will be done by video/ phone call.

Before attending the appointment, participants will be asked to complete a checklist to identify any needs they have in relation to their mini stroke (TIA) or minor stroke. At the appointment, the nurse/ therapist will discuss these needs and how to address them. Participants will be given an action plan for how to address their needs and a list of support services and resources which may be helpful.

There will be an option to have more follow-up appointments if it is needed.

The study is funded by the National Institute for Applied Health Research (NIHR) Postdoctoral Fellowship (PDF_2017_10_047).

TIA and minor stroke: a qualitative study of long-term impact and experiences of follow-up care. Turner G, McMullan C, Atkins L, Foy R, Mant J, Calvert M. BMC Family Practice. 2019; 20:176.

Using a checklist to facilitate management of long-term care needs after stroke: insights from focus groups and a feasibility study. Turner G, Mullis R, Lim L, Kreit L, Mant J. BMC Family Practice. 2019; 20:2

Establishing research priorities relating to the long-term impact of TIA and minor stroke through stakeholder-centred consensus. Turner GM, Backman R, McMullan C, Mathers J, Marshall T, Calvert M. Research Involvement & Engagement. 2018 25;4(2).

Ongoing impairments following transient ischaemic attack: retrospective cohort study. European Journal of Neurology. Turner GM, Calvert M, Feltham MG, Ryan R, Marshall T. 2016; 23(11):1642-1650

Fatigue, psychological and cognitive impairment following transient ischaemic attack and minor stroke: a systematic review. Turner G, Feltham M, Calvert M, Marshall T. European Journal of Neurology. 2014;21(10)1258-1267