Evidence map›Paper›PMID 40684242›Full record

ArticleTrials2025

Implementing a new model of primary care for stroke survivors living in the community: a mixed-methods process evaluation.

Maria Raisa Jessica Aquino, Grace Turner, Elizabeth Kreit, Emily G Blatchford, Julie Grant, Vicki Johnson, Ricky Mullis, Jonathan Mant

Registry-linked trialAbstract read
In one paragraph

Article in Trials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03353519 (Improving Primary Care After Stroke), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

NCT03353519 nacompletednot on this map

Improving Primary Care After Stroke (IPCAS): A Randomised Controlled Trial to Evaluate a New Model of Care for Stroke Survivors Living in the Community

TypeinterventionalSponsorUniversity of CambridgeRan2018 to 2020Enrolled1,041ConditionsStrokeArmsPrimary care model
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Maria Raisa Jessica AquinoPopulation Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK. ryc.aquino@newcastle.ac.uk.ORCID http://orcid.org/0000-0002-3989-1221
Grace TurnerSchool of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
Elizabeth KreitNational Institute for Health and Care Research BioResource Centre, Cambridge, UK.
Emily G BlatchfordPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Julie GrantPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Vicki JohnsonUniversity Hospitals Leicester NHS Trust, Leicester Diabetes Centre, Leicester, UK.
Ricky MullisPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Jonathan MantPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.

Funding

Programme Grants for Applied Research PTC-RP-PG-0213-20001
6 · The paper itself

Abstract

backgroundSurvival after stroke is improving, leading to increased demand on primary care and community services to meet the long-term care needs of people living with stroke. Improving Primary Care After Stroke (IPCAS) is a novel model of primary care for stroke survivors living in the community. IPCAS was a complex intervention, with intervention components aimed at stroke survivors and healthcare professionals. This process evaluation aimed to explore how the intervention was delivered in context and how participants engaged with the intervention.

methodsThe process evaluation was underpinned by the National Institute of Health's Behaviour Change Consortium fidelity framework. A mixed methods design was used to assess fidelity of design, training, delivery and engagement. Methods included questionnaires, video- and audio-recordings, observations, and interviews with staff and participants.

resultsThe IPCAS intervention reflected its theoretical underpinnings and was substantially different from usual care. Most components of the intervention were delivered with high or moderate fidelity and training fidelity was high. In particular, the checklist was considered useful. However, other components were less valued, in particular, the direct point of contact service which was hardly used by participants and the local directory of services which had variable take up by healthcare professionals. It was not possible to facilitate communication between primary and secondary care as originally planned. Furthermore, some practices used a GP or healthcare assistant to deliver the reviews, rather than a practice nurse as planned. Several participants did not feel the intervention was relevant for them due to their recovery and the time that had passed since their stroke.

conclusionsThis mixed-methods process evaluation provided novel insights into the design, delivery and engagement with a new model of primary care for stroke survivors. Despite high or moderate fidelity for delivery of most components of the intervention and high training fidelity, some components, such as the direct point of contact, were not valued and several participants did not feel the intervention was relevant for them.

trial registrationClinicalTrials.gov NCT03353519. Registered on November 27, 2017.

Indexed as

Community Health ServicesDelivery of Health Care, IntegratedIndependent LivingPrimary Health CareStrokeStroke RehabilitationSurvivorsHumansProcess Assessment, Health CareIntervention fidelityPrimary careProcess evaluationStroke

Identifiers

PMID40684242
PMCPMC12276669

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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.