Theme: Implementation

Project Description

The INTERFACE Study aims to investigate stroke secondary prevention (SSP) in the United Kingdom (UK), with a view to future work looking at designing a new SSP intervention at the interface between primary and secondary care. This will be achieved through four work packages:

Work Package 1: A systematic review and meta-analysis will assess current literature on SSP, including existing recommended pharmacological therapies, drug treatment targets, and non-pharmacological therapies.

Work Package 2: This package will utilise the Clinical Practice Research Datalink (CPRD) to assess real-world primary care performance of SSP in the UK. This will explore medications used, timelines taken to achieve prevention targets, and correlate SSP to key health outcomes, including stroke recurrence. Additional analyses will consider the role of social determinants of health (including geographical and socioeconomic differences) and evaluate whether we can predict those at greatest risk of not achieving adequate SSP.

Work Package 3: Existing models of post-stroke care will be assessed, including the stroke Advice and Guidance (A&G) system in Leicester. The effectiveness of the existing service will be evaluated and compared to other locally used models of care. The topics raised in A&Gs from primary care will also be assessed to identify themes which may represent barriers to SSP or gaps in existing services.

Work Package 4: This module will use qualitative methods to better understand experiences with SSP, including lived experience from stroke survivors and professional experiences from healthcare professionals. Barriers to SSP will be considered, including exploring the impact of different motivators and the psychological sequalae of stroke on behaviour change.

This is a timely project, aligning with the new NHS 10-year plan, focusing on prevention, community-based care, and incorporating digital methods. Based in the Midlands, this study is well-placed to draw on local expertise, and explore barriers faced by underserved communities.