Active provision of information to stroke survivors favoured over passive approaches

Active provision of information to stroke survivors favoured over passive approaches

Vanessa Jordan
PEARLS No.
691
Clinical question

What are the effects of active or passive information provision for stroke survivors or their identified carers?

Bottom line

This review found evidence that the addition of active information provision to usual care may slightly improve some important stroke survivor outcomes. Actively providing information may improve knowledge of stroke and stroke services, increase some aspects of stroke survivor satisfaction, slightly reduce cases and symptoms of anxiety and depression in stroke survivors, and improve quality of life.

Active interventions included information courses, interactive follow-up phone conversations or review by stroke nurse specialists.

However, providing information passively may have a slightly negative effect on survivor anxiety and depression. Passive information consisted of generic information provided by pamphlet.

There was no direct evidence comparing active and passive information provision. Observation of the indirect comparison via usual care, which must be interpreted with caution, suggests there may be a divergence of effect on stroke survivor symptoms of anxiety and depression.

Caveat

There was extensive variation in the content and delivery format of the interventions. Few studies included participants with aphasia and cognitive problems. This substantially limits the applicability of the results, given that approximately one-third of stroke survivors experience aphasia and even more experience cognitive impairment.

Reviewers did not have high confidence in the estimate of effect for any of the outcomes as there was high risk of bias from the included studies, with serious concerns over attrition from the studies. In addition, although there were some data to address the primary outcomes and the majority of secondary outcomes for this review, few studies contributed to each of the outcomes studied.

Context

Context A stroke is a sudden loss of brain function caused by lack of blood supply. Stroke can lead to death or physical and cognitive impairment, and can have long-lasting psychological and social implications.

Research shows stroke survivors and their families are dissatisfied with information provided to them and have a poor understanding of stroke and associated issues.

Cochrane Systematic Review

Crocker TF, et al. Information provision for stroke survivors and their carers. Cochrane Database Syst Rev 2021;11:CD001919. This review contains 33 trials with a total of 5255 stroke survivors and 3134 carers.