ReviewBMC health services research2019
How unmet are unmet needs post-stroke? A policy analysis of the six-month review.
Review in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 6 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Primary care-based interventions for post-stroke follow-up for long-term care: a systematic review.Family practice · 2026Pooled it
- Adaptive Interventions for Enhancing Participation Poststroke: A Systematic Review and Meta-Analysis.Canadian journal of occupational therapy. Revue canadienne d'ergotherapie · 2026Pooled it
- Research progress of quantitative electroencephalography in post-ischemic stroke mental disorders.Frontiers in neurology · 2025Pooled it
- International research priority setting exercises in stroke: A systematic review.International journal of stroke : official journal of the International Stroke Society · 2023Pooled it
- Information provision for stroke survivors and their carers.The Cochrane database of systematic reviews · 2021Pooled it
- The Unmet Needs of Community-Dwelling Stroke Survivors: A Systematic Review of Qualitative Studies.International journal of environmental research and public health · 2021Pooled it
- Using evidence briefs to support future implementation planning: the case of early fibrinolysis for myocardial infarction and rehabilitation for the amputee patient in Colombia.Health research policy and systems · 2026Article
- Virtual Assistant as a Companion for Stroke Survivors post Discharge: Thematic Analysis Highlights Expectations of Human Performance Pose a Key Barrier to Engagement.Cerebrovascular diseases (Basel, Switzerland) · 2026Article
- Stroke survivors' and carers' experiences of nutritional care after stroke: a qualitative study.Frontiers in stroke · 2026Article
- Implementing and sustaining 6-month post-stroke reviews: a complexity-informed, context-sensitive programme theory for clinical practice.Frontiers in stroke · 2026Article
- Unique Needs and Challenges Experienced by Young People With Stroke: An International Qualitative Analysis.Neurology. Clinical practice · 2025Article
- Exploring variation in the six-month review for stroke survivors: a national survey of current practice in England.BMC health services research · 2025Article
- Technology for Young Adults with Stroke: An Australian Environmental Scan.International journal of environmental research and public health · 2024Review
- Experiences of chain of care and rehabilitation after stroke: a qualitative study of persons discharged to skilled nursing facilities before returning home.Journal of rehabilitation medicine · 2024Article
- Exploring different stroke populations' information needs: a cross-sectional study in England.Archives of public health = Archives belges de sante publique · 2024Article
- Implementation of evidence-based interventions according to the Swedish National Guidelines for Strokecare: a nationwide survey among physiotherapists.Journal of rehabilitation medicine · 2024Article
- Co-creation of self-management support during inpatient stroke rehabilitation.PEC innovation · 2023Article
- Long-term psychological outcomes following stroke: the OX-CHRONIC study.BMC neurology · 2023Article
- Age-specific information resources to address the needs of young people with stroke: a scoping review protocol.Systematic reviews · 2022Article
- Exploring Stroke Patients' Needs after Discharge from Rehabilitation Centres: Meta-Ethnography.Behavioral sciences (Basel, Switzerland) · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
backgroundStroke is the fourth largest cause of death in the UK and a leading cause of death and disability worldwide. Policy recommends reviewing patients at six-months post-stroke to identify unmet needs but lacks evidence of effectiveness. This study explored needs identified by patients, how they were addressed by the six-month review (6MR) and whether or not policy aspirations for the review were substantiated by the data.
methodsA multiple case study design underpinned by critical realism. Data sources included interviews with 46 patients and 28 professionals across three sites in the South East Coast of England. Patients' interviews coincided with their reviews of which twenty-nine were observed. Thematic analysis of interviews, observations and policy documents was carried out within and across sites.
resultsThere were 'hotspots' in the care pathway where patients and carers felt particularly unsupported. Whilst these gaps exacerbated anxiety, they were neither universal nor ameliorated by review. Patients consistently identified unmet needs related to rehabilitation, information/education and support. Stroke nurse specialists focused on investigations, medication and liaising with general practitioners or consultants while the Stroke Association co-ordinator focused on sign-posting to other services and provision of generic information which not all respondents found helpful. The remit of review was more modest than that of policy aspirations.
conclusionsThe review rests on two causal assumptions: that identifying unmet need will lead to its amelioration; and that provision of information will lead to behaviour change and self-management. While there was some evidence to support the former, there was almost none for the latter. The 6MR would benefit from a patient-led approach to its timing and format; a consistent and individualised approach to stroke education and self-management that is embedded across the care pathway; and targeting reviews should be considered.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.