Enhanced reviews of psychological changes after stroke (ENRICH)
Research type
Research Study
Full title
ENhanced Reviews of psychologIcal CHanges after stroke (ENRICH): Acceptability of the ENRICH reviews and feasibility of a stepped-wedge cluster randomised controlled trial
IRAS ID
336341
Contact name
Nele Demeyere
Contact email
Sponsor organisation
University of Oxford / Research Governance, Ethics, and Assurance
Duration of Study in the UK
2 years, 11 months, 30 days
Research summary
National clinical guidelines emphasise the importance of cognitive impairment screening (attention, memory, spatial awareness, apraxia, perception) in the early stages post-stroke (NICE guideline 162, June 2013). Assessing cognition after stroke is essential due to its high prevalence (91%; Milosevich et al., 2023).
Cognitive support from hospital to community-based care is also important as cognitive impairment persists for up to 9 years post-stroke (up to 45%; Kusec et al, 2023). Stroke survivors are also at a three-times increased risk of developing dementia (Kuzma et al., 2018). Combined, cognitive impairment can increase risk for depression (Harman-Maeier et al., 2007) and reduced quality of life (Nys et al 2005). Unsurprisingly, 74.6% of stroke survivors report managing a cognitive changes as a substantial unmet need (Chen et al., 2019) - 50% report receiving inadequate care (Stroke Association, 2016).
There is therefore a need to develop a standardised approach within the stroke care pathway to 1) assessing cognitive changes using sensitive and appropriate assessments and 2) monitor and support post-stroke cognition and its impact on quality of life.
Here, we outline a two-part study on the ENhanced Reviews of psychologIcal CHanges after stroke (ENRICH) intervention, co-designed with stroke survivors, carers, and clinicians. The ENRICH intervention provides a cognitive screening assessment, psychoeducation and self-management strategy support at 1-month, 3-months, and 6-months post-stroke.
In Study 1 we aim to refine ENRICH intervention materials by having stroke health care professionals (n = 5) use materials with a small sample of stroke survivors (n = 15) and carers (n = 10) as part of a one-off ENRICH session within a single NHS service. Study 2 will evaluate the feasibility of the full ENRICH intervention across 2 UK-wide NHS Trusts using a stepped-wedge cluster randomised controlled trial.
REC name
London - Brighton & Sussex Research Ethics Committee
REC reference
24/LO/0341
Date of REC Opinion
4 Jun 2024
REC opinion
Further Information Favourable Opinion