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116 Development of a complex intervention as part of the strokecompass study
  1. Anne-Marei Jarchow1,
  2. Denise Wilfling1,
  3. Julia Peper1,
  4. Jasmin Helbach2,
  5. Falk Hoffmann2,
  6. Christoph Heesen3,
  7. Götz Thomalla4,
  8. Anne C Rahn1
  1. 1Institute for Social Medicine and Epidemiology, Nursing Research Unit, University of Lübeck, Lübeck, Germany
  2. 2Department of Health Services Research, University of Oldenburg, Oldenburg, Germany
  3. 3Institute for Neuroimmunology and Multiple Sclerosis, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
  4. 4Department of Neurology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany


Introduction Evidence-based treatment options are available to minimise the risk of suffering from a recurrent stroke. The StrokeCompass project aims to develop a nurse-led coaching intervention to support people with stroke (PwS) in secondary prevention medication decision-making and promote adherence by strengthening empowerment.

Methods StrokeComposs follows the MRC framework for developing and evaluating complex interventions. The programme will consist of the following components: Decision coaching, a web-based decision aid, and adherence coaching. We will develop the components based on evidence synthesis on information needs of PwS (scoping review) and adherence promotion using motivational interviewing (MI, systematic review). The decision aid will be based on current evidence for the medication of blood pressure, anticoagulation and statins. A questionnaire to address stroke and recurrent prevention knowledge will be developed based on previous work and validated in a web-based survey with around 200 PwS. To explore conditions for decision-making and factors influencing medication adherence, we are conducting a multiple case study on 6 PwS and their surroundings using semi-structured interviews at different time points after stroke.

Results The scoping review on information needs (n=36 studies) revealed treatment, aetiology of stroke and personalised information as the top three needs. The systematic review on MI (n=4 studies) showed inconclusive results on medication adherence.

So far, we have performed seven interviews (PwS=4, relatives=2, health professional=1). All respondents described a passive role of PwS and a lack of sufficient communication. A decision-making process was not visible. Further results and the intervention programme will be presented at the conference.

Discussion The results of the literature and case studies indicate the need for timely decision support after a stroke.

Conclusion The results provide essential information to develop a feasible complex intervention that supports PwS taking an active role in decision-making in recurrent stroke prophylaxis and medication management.

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