Evidence map›Paper›PMID 40013060›Full record

ArticleJournal of multimorbidity and comorbidity

Implementation of the virtual transitional care stroke intervention for older adults with stroke and multimorbidity: A qualitative descriptive study.

Maureen Markle-Reid, Kathryn Fisher, Kimberly M Walker, Jill I Cameron, David Dayler, Rebecca Fleck, Amiram Gafni, Rebecca Ganann, Ken Hajas, Barbara Koetsier and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of multimorbidity and comorbidity. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Maureen Markle-ReidSchool of Nursing, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0002-4019-7077
Kathryn FisherSchool of Nursing, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0001-8342-1238
Kimberly M WalkerUpstream Lab, MAP Centre for Urban Health Solutions, St Michael's Hospital, Unity Health, Toronto, ON, Canada.
Jill I CameronDepartment of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
David DaylerAging, Community and Health Research Unit, McMaster University, Hamilton, ON, Canada.
Rebecca FleckParkwood Institute, St. Joseph's Health Care, London, ON, Canada.
Amiram GafniHealth Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Rebecca GanannSchool of Nursing, McMaster University, Hamilton, ON, Canada.
Ken HajasAging, Community and Health Research Unit, McMaster University, Hamilton, ON, Canada.
Barbara KoetsierAging, Community and Health Research Unit, McMaster University, Hamilton, ON, Canada.
Robert MahonyAging, Community and Health Research Unit, McMaster University, Hamilton, ON, Canada.
Chris PollardHotel Dieu Shaver Health and Rehabilitation Centre, St. Catherines, ON, Canada.
Jim PrescottAging, Community and Health Research Unit, McMaster University, Hamilton, ON, Canada.
Tammy RookeCarePartners, Kitchener, ON, Canada.
Carly WhitmoreSchool of Nursing, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0002-3974-4854

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Older adults with stroke and multimorbidity experience frequent care transitions, which are often poorly coordinated and fragmented. We conducted a pragmatic randomized controlled trial (RCT) to test the implementation and effectiveness of the Transitional Care Stroke Intervention (TCSI), a 6-month, multi-component, evidence-informed intervention to support older adults with stroke and multimorbidity using outpatient stroke rehabilitation services. The TCSI was designed to support self-management, improve health outcomes, and enhance the quality and experience of care transitions. Objective: To explore the facilitators and challenges to implementing the TCSI, from the perspective of healthcare providers (HCPs) (n = 12) and Managers (n = 3). Methods: Data collection and analysis were guided by the Consolidated Framework for Implementation Research (CFIR). Data were collected from study documents, individual and group interviews conducted with HCPs and a Care Coordinator, and surveys from managers. Data were analyzed using thematic analysis. Results: Intervention implementation was facilitated by: a) strong collaborative and interdependent HCP team relationships, b) dedicated resources (funding, staffing) to support intervention delivery, c) training and ongoing support, customized to individual HCP needs, d) organizational readiness, strong leadership, and effective champions, e) structures to facilitate virtual information-sharing, and f) regular monitoring of intervention implementation. Implementation challenges included: a) COVID-19 related challenges (staff turnover, community service disruptions), b) poor communication with community service providers, c) documentation burden (intervention-related), and d) virtual care delivery. Conclusions: This research enhances understanding of the diversity of factors influencing implementation of the TCSI, and the conditions under which implementation is more likely to succeed.

Indexed as

implementationmultimorbidityOlder adultsstroke rehabilitationtransitional care intervention

Identifiers

PMID40013060
PMCPMC11863252

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.